Customer service department regulations
Last revision: 05/07/2022
REGULATIONS OF THE CUSTOMER SERVICE DEPARTMENT
(adapted to Law 2/2011, of 4 March, on Sustainable Economy and Order ECC/2502/2012):
MODEL REGULATIONS OF OPERATION OF THE CUSTOMER SERVICE DEPARTMENT OF THE C1 INSURANCE BROKERAGE C1 Broker: Wiseg Mediación de Seguros SL
Name : Wiseg Mediación de Seguros SL (C1 Broker)
TAX IDENTIFICATION NUMBER: B76774298
Address: Avda. Barranco de las Torres, Ed. CC Domasa, local 104, 38670 Adeje
Supervisory body : DGSFP
Registered in the Administrative Register of Insurance and Reinsurance Distributors : DGSFP J-3790
REGULATIONS FOR THE DEFENCE OF INSURANCE BROKERAGE CLIENTS.
These regulations govern the operation of the Insurance Brokerage Customer Care Department or Service, in accordance with the provisions of Order ECO 734/2004, of 11 March, on customer care departments and services and the financial institution customer ombudsman (hereinafter, “Order 734/2004”).
1 – GENERAL DISPOSITIONS
Article 1.- Purpose and applicable legislation
The purpose of the Department or Customer Care Service of the Insurance Brokerage Firm is to attend to and resolve the complaints and claims presented by its clients in relation to their legally recognised interests and rights, in accordance with the provisions of the regulations on the protection of financial services clients, and specifically, in accordance with article 166 of Royal Decree-Law 3/2020, of 4 February, on urgent measures by which various European Union directives in the field of public contracts in certain sectors are incorporated into the Spanish legal system; private insurance; pension plans and funds; taxation and tax litigation.
The purpose of these Regulations is to regulate the activity, operation and internal rules of the Customer Service Department or Service and, where appropriate, the Customer Ombudsman, as well as the relations between the two and, consequently, the processes relating to the processing and resolution of complaints and claims submitted by customers of the Brokerage related to their legally recognised interests and rights.
The Regulations have been adapted to the new legislation enacted and specifically to the provisions of art. 31 and the Eleventh Final Provision of Law 2/2011, of 4 March, on Sustainable Economy, which have modified the Spanish system for dealing with complaints in the financial sector, with regard to complaints and queries to the competent services of the financial and insurance supervisory bodies, with the express purpose of protecting the rights of customers in each of the three areas of financial activity: banking, securities and insurance. Furthermore, these regulations are adapted to Order ECC/2502/2012 of 16 November regulating the procedure for submitting complaints to the complaints services of the Bank of Spain, the National Securities Market Commission and the Directorate General of Insurance and Pension Funds (hereinafter “Order 2502/2012”), which regulates the procedure for submitting complaints to the complaints services of the Directorate General of Insurance and Pension Funds.
Therefore, it is an essential aim of the Insurance Brokerage to provide a quality and transparent service, with full guarantees for the client so that they can formulate their claims in the most appropriate way and with absolute attention to their interests.
Article 2.- Constitution and scope of action
2.1. Acting in compliance with current legislation and in order to adopt protective measures for customers, as well as to attend to and resolve any complaints and claims that customers may present in relation to the rights to which they are entitled by law, the corresponding Customer Service Department or Service is created.
2.2. The Customer Service Department or Service has autonomy in the taking of decisions relating to the scope of its activity and in the avoidance of conflicts of interest.
2.3. The Customer Service Department or Service shall be equipped with the appropriate human, material, technical and organisational resources for the fulfilment of its functions.
2.4. Responsibility for dealing with complaints and claims submitted shall correspond entirely to the Customer Service Department or Service, and especially to its owner.
CUSTOMER SERVICE DEPARTMENT OR SERVICE
Article 3.- Head of the Customer Attention Department or Service
3.1. The Head of the Customer Service Department or Service is a person of commercial and professional integrity, with adequate knowledge and experience to carry out the functions required by the regulations in force.
3.2. The Head of the Customer Care Department or Service may be a legal entity, represented in this case by a natural person, and will be appointed by the Insurance Brokerage.
3.3. The following shall be causes of incompatibility and ineligibility of the Head of the Customer Care Department or Service:
To be incapacitated to exercise commerce in accordance with article 13 of the Royal Decree of 22 August 1885, which publishes the Code of Commerce;
Simultaneously holding a position working for other financial institutions outside the group;
Simultaneously holding the post of Customer Ombudsman for any financial institution;
Simultaneously perform functions in the other commercial or operational services of the organisation.
In particular, it will not be able to be designated Head of the Department or Service of Attention to the Client, who simultaneously carries out functions in the commercial department, or in the operative services of the Insurance Brokerage, such as marketing, subscription or processing of claims.
The designation shall be communicated to the Directorate General of Insurance and Pension Funds of the Ministry of Economy and Finance or, where appropriate, to the competent body of the Autonomous Community in the event that the Brokerage acts only in this territorial area within a maximum period of ONE (1) MONTH from its designation.
Likewise, the designation will be published in the Insurance Brokerage’s own media such as, where appropriate, the company’s website and notice board.
Article 4.- Appointment and term of office
4.1. The appointment of the Head of the Customer Service Department or Service will have the duration of ONE (1) YEAR and will be tacitly renewed for equal periods of time, being able to be revoked at the discretion of the Insurance Brokerage, according to the circumstances that make it advisable.
4.2. The Head of the Customer Service Department or Service shall cease to hold office for any of the following reasons:
Incurring in any cause of incompatibility or ineligibility;
Absolute incapacity to work for the usual profession.
In the event of a vacancy in the post, and without prejudice to the fulfilment of the resolutions adopted by the previous Holder, which will have full validity on the matters submitted for their consideration, the Insurance Brokerage will proceed to the appointment of a new Holder within TWO (2) MONTHS following the vacancy.
Article 5.- Obligations of the Insurance Brokerage with respect to the Department or Service of Attention to the Client.
5.1. The Insurance Brokerage will adopt the necessary measures to functionally separate the Customer Service Department or Service from the other commercial or operational services of the organisation, in such a way as to guarantee that the Head of the Customer Service Department or Service can autonomously and independently adopt his decisions regarding the scope of his activity, and, likewise, to avoid conflicts of interest.
5.2. The Insurance Brokerage Firm shall adopt the appropriate measures to guarantee that the procedures foreseen for the transmission of the information required by the Customer Service Department or Service to the rest of the organisation’s services respond to the principles of speed, security, efficiency and coordination.
5.3. The Insurance Brokerage shall ensure that its Customer Service Department or Service is equipped with the appropriate human, material, technical and organisational resources for the fulfilment of its functions. In particular, it shall adopt the necessary measures so that the Holder has the conditions that guarantee its work without undermining its independence in decision-making.
Article 6.- Matters for the knowledge of the Customer Service Department.
Any matter affecting the brokerage’s mediating activity may be submitted to the Department or Customer Service of the Insurance Brokerage, due to any action or omission in the performance of the professional activity that could suppose a damage or deficiency of operation that affects the clients, and that suppose a violation of the principles of quality and professionalism in the service to which the insurance brokerages are obliged with respect to their clients.
In particular, the following may be submitted to the Registrant for consideration, by way of example and without limitation:
Errors in the issuing of policies due to the inadequacy of the insurance to the client’s mandate;
Deficiencies in the information provided to clients that have caused damage or undermined their rights as consumers;
Lack of action or lack of understanding in the management of customer requests;
Undermining the dignity of the customer through offensive, inappropriate or humiliating treatment;
Failure to comply with the Brokerage’s obligations regarding access, modification, cancellation and security of clients’ personal data;
Delays in the communication of decisions taken by the Insurance Companies;
Lack of transparency and information from them;
Failure to recover documentation that served as the basis for the analysis of a specific rejected operation;
Delay in the communication to different insurance entities of information provided by the clients;
Any other complaint that could be considered a deficient insurance mediation service and is not in accordance with the standards of conduct applicable to the uses of the profession.
COMPLAINTS AND CLAIMS
Article 7.- Procedure for submitting complaints: form, content and place of submission.
Claims or complaints addressed to the Customer Care Department or Service must contain:
The identification details of the claimant, name and surname, or company name in the case of legal persons, address for notification purposes and identification number of the natural persons or entities, or, where appropriate, details of the public register of the entity in question. If the application is presented through a representative, proof of representation shall be provided by any legally accepted means;
The identification of the insurance brokerage that is the object of the complaint, as well as the office or branch to which the claim or complaint refers;
The reason for the claim or complaint presented in relation to their legally recognised interests and rights, expressly stating whether the claim or complaint is pending resolution or litigation before administrative, arbitration or jurisdictional bodies;
Place, date and signature.
Claims or complaints must be accompanied by any documentation that is essential for resolving the issues raised in the claim or complaint, without prejudice to the Head of the Customer Service Department or Service Department requesting from the Insurance Brokerage the documentation that should be in their possession in relation to the claim or complaint.
The presentation of complaints and claims may be made, in person or by proxy, on paper or by computer, electronic or telematic means provided for in Law 6/2020, of 11 November, regulating certain aspects of electronic trust services (hereinafter, “Law 6/2020”), provided that these allow the reading, printing and conservation of the documents. They may also be submitted by e-mail to firstname.lastname@example.org.
The Customer Services Department or Service may obtain, by any means, the documents necessary to accredit the true identity of the claimant.
Article 8.- Deadline for submitting complaints
The deadline for submitting complaints or claims to the Customer Service Department or Service must be made within TWO (2) YEARS from the date on which the customer becomes aware of the facts giving rise to them.
Article 9.- Procedure for processing complaints. Time limit for issuing the ruling.
The Customer Service Department or Service will have a period of TWO (2) MONTHS to resolve the complaint or claim, counting from its presentation – and within ONE (1) MONTH in the event that the claim has been lodged by a consumer -, and the claimant may, after the end of this period, turn to the competent bodies for the handling of claims of the Directorate General of Insurance, or, where appropriate, of the Autonomous Community, in accordance with Order ECC/2502/2012, which regulates the procedure for submitting complaints to the complaints services of the Directorate General for Insurance and Pension Funds, or, where appropriate, to the competent courts and tribunals, of which the claimant shall be expressly informed in the aforementioned pronouncement.
Once the complaint or claim has been received by the Insurance Brokerage, in the event that it has not been resolved in favour of the client by the office or service that is the object of the complaint or claim, it shall be forwarded to the Customer Service Department or Service, who, when appropriate in accordance with these Operating Regulations, shall proceed to process it.
In any case, receipt shall be acknowledged in writing and a record shall be made of the date of presentation for the purposes of calculating the time limit for pronouncement.
Once the complaint or claim has been received by the body responsible for processing it, a file shall be opened.
The complaint or claim shall be presented only once by the interested party, without being able to demand its reiteration before different bodies of the Insurance Brokerage.
If the identity of the claimant is not sufficiently accredited, or if the facts that are the object of the complaint or claim cannot be clearly established, the signatory shall be required to complete the documentation sent within TEN (10) calendar DAYS, with the warning that if he/she fails to do so, the complaint or claim shall be filed without further processing.
The period used by the claimant to rectify the errors referred to in the previous paragraph shall not be included in the calculation of the TWO (2) MONTH period -and in the period of ONE (1) MONTH in the event that the complaint has been filed by a consumer-, for the issuing of a ruling by the Customer Service Department or Service or the Customer Ombudsman.
The Customer Care Department or Service, and where appropriate the Customer Ombudsman if this Department or Customer Care Service has been created voluntarily by the Brokerage, may, during the course of the processing of the files, request from the complainant and from the different departments and services of the affected entity, any data, clarifications, reports or evidence they consider relevant to adopt their decision.
If, in view of the complaint or claim, the Brokerage rectifies its situation with the claimant to the latter’s satisfaction, it shall notify the Head of the Customer Service Department or Service and justify it with documents, unless the interested party expressly withdraws. In such cases, the complaint or claim shall be filed without further action.
The file must be finalised within a maximum period of TWO (2) MONTHS – and within ONE (1) MONTH in the event that the complaint has been filed by a consumer – from the date on which the complaint or claim was submitted to the Customer Service Department or Service or, where appropriate, the Customer Ombudsman.
Article 10.- Internal processing of complaints
All complaints and claims received by the Brokerage, either through the web page or the special e-mail account opened for this purpose, shall be received immediately by the Customer Service Department or Service, which shall proceed to analyse them, acknowledging receipt in writing and recording the date of their presentation, in order to keep a due computation of the period.
The person in charge of the Customer Care Department or Service shall proceed to open the file and study the complaint or claim received, requesting all the necessary information or documentation, and resolving accordingly.
Article 11.- Grounds for rejection in the processing of the complaint and withdrawal of the customer.
Customer complaints and claims may only be rejected for processing in the following cases:
When essential data for processing that cannot be rectified is omitted, including cases in which the reason for the complaint or claim is not specified;
When the complaint or claim is intended to be processed as a complaint or claim, appeals or different actions whose knowledge is the competence of administrative, arbitration or judicial bodies, or the same is pending resolution or litigation or the matter has already been resolved in those instances;
When the facts, reasons and request specifying the issues that are the subject of the complaint or claim do not refer to specific operations or do not comply with the requirements established in section 2.2 of article 2 of Order ECO 734/2004. That is, of obligations referring to the condition of user or third parties harmed by the services of the insurance brokerage provided that such complaints and claims refer to their legally recognised interests and rights, whether they derive from contracts, from the regulations on transparency and customer protection or from good financial practices and uses, and in particular, from the principle of fairness;
When complaints or claims are made that reiterate other previously resolved complaints or claims submitted by the same customer in relation to the same facts;
When the period for the presentation of complaints and claims established in these operating regulations of TWO (2) YEARS has elapsed;
When it becomes aware of the simultaneous processing of a complaint or claim and an administrative, arbitration or judicial proceeding on the same matter, it shall refrain from processing the former.
When the complaint or claim is deemed inadmissible for any of the aforementioned reasons, it shall be notified to the interested party by means of a reasoned decision, giving him/her a period of TEN (10) calendar DAYS to present his/her allegations. When the interested party has replied and the reasons for rejection are maintained, the final decision adopted will be communicated to the interested party.
Interested parties may withdraw their complaints and claims at any time and without the need to allege a justifying cause. Withdrawal shall result in the immediate termination of the procedure as far as the relationship with the interested party is concerned. However, the Head of the Customer Service Department or Service may agree to continue the same, for the purpose of encouraging the necessary improvements in the insurance brokerage, and within the framework of its function of promoting compliance with the regulations on transparency and customer protection and the good practices and uses of insurance mediation.
Article 12.- Cancellation and withdrawal.
12.1. In the event that the Brokerage rectifies its situation with the complainant to its satisfaction, it shall notify the competent body and justify its decision with documentary support, unless the interested party expressly withdraws. In the latter case, the complaint or claim shall be archived.
12.2. The interested parties, as indicated in the previous precept, may also withdraw their complaint or claim at any time after its presentation, causing it to be filed. However, the Customer Ombudsman may agree to continue with the same in order to comply with the provisions of the regulations on transparency and customer protection and good practices.
Article 13.- Termination and notification
13.1. As indicated in Article 9.10 of these Regulations, the file must be finalised within a maximum period of TWO (2) MONTHS from the date on which the complaint or claim is filed with the Customer Service Department or Service, or within ONE (1) MONTH in the event that the claim has been filed by a consumer.
13.2. The decision shall be reasoned, containing clear conclusions on all the points raised in the request.
13.3. The decision shall be notified to the interested parties within TEN (10) calendar DAYS from the date on which it was issued. Notification may be made by any means (e-mail, electronic office, post, etc.) provided that the requirements for reading, printing and conservation of the documents are met.
Article 14.- Decision or pronouncement of the Customer Service Department or Service. Recording and control of decisions or pronouncements.
The decision, or pronouncement, shall always be reasoned and shall contain clear conclusions on the request made in each complaint or claim, based on the contractual clauses, the applicable rules of transparency and customer protection, as well as the good practices and uses of insurance mediation.
In the event that the decision deviates from the criteria expressed in previous similar cases, reasons shall be given.
The decision shall be notified to the interested parties within TEN (10) calendar DAYS from its date, in writing or by computer, electronic or telematic means, provided that these allow the reading, printing and conservation of the documents, and comply with the requirements set forth in Law 6/2020, as expressly designated by the claimant and, in the absence of such indication, through the same means in which the complaint or claim was submitted.
The Head of the Customer Service Department or Service shall keep a record of the complaints made to him/her, with a record of the file number and the year in which the file was opened, with the name of the complainant, which may serve as technical and legal background for application to any other similar or analogous cases, as a source of doctrinal pronouncements that may in turn serve as guiding criteria for future cases.
Article 15.- Annual report of the Head of the Customer Service Department or Service.
Within the first quarter of each year, the Department or Service of Attention to the Client, will present to the Insurance Brokerage, an explanatory report of the development of its function during the preceding exercise, with the following minimum content:
Statistical summary of the complaints and claims dealt with, with information on their number, admission for processing and reasons for rejection, motives and questions raised in the complaints and claims, and amounts and amounts affected;
Summary of the decisions issued, indicating whether they were favourable or unfavourable to the complainant;
General criteria contained in the decisions;
Recommendations or suggestions derived from its experience, with a view to better achieving the aims that inform its actions.
Said report shall be included, where appropriate, in the annual report of the insurance brokerage.
Article 16.- Publicity about the Customer Service Department or Service.
The insurance brokerage shall make the following information available to its clients in each and every one of the offices open to the public, as well as on its web pages in the event that the contracts have been concluded by telematic means:
The existence of a Customer Care Department or Service and, where appropriate, a customer ombudsman, with an indication of their postal and e-mail address;
The obligation on the part of the institution to attend to and resolve the complaints and claims submitted by its customers within TWO (2) MONTHS of their submission to the Customer Care Department or Service or, where appropriate, the Customer Ombudsman – and within ONE (1) MONTH in the event that the claim has been lodged by a consumer;
The operating regulations provided for in the previous article;
References to the regulations on transparency and protection of financial services customers.
These Regulations shall enter into force on 22/06/2022 (date of approval) by the Brokerage.
The provisions of Order ECO 734/2004 shall apply in addition to the provisions of the Regulation.