Small claims before the Insurance Commission
This notwithstanding, a claimant still has the means to seek redress of his or her grievance without immediately resorting to courts of law
Published in Daily Tribune on May 7, 2021
by: Migmar Bernped S. Francisco
Figuring in an accident is always a troublesome predicament. Aside from the usual emotional and mental strain one undergoes, it is also accompanied by unexpected losses and expenses. This is where having an insurance policy may come in handy.
Insurance is a means of indemnifying a person for some loss or damage caused by the occurrence of a risk or peril insured against. Having an insurance policy is different, however, from successfully claiming benefits under it.
There are instances when an insurer may deny a claim against the insured’s protestation of entitlement thereto.
While the insured believes that he or she has a compelling case against the insurer and is entitled to collect under the insurance policy, the insured is often discouraged from pursuing his or her claim thinking it can only be done through a lawsuit.
Faced with the prospect of a rigid and lengthy legal processes, which may result in protracted litigation, the insured is likely to just abandon his claim especially when the claim is nominal. They think that the time, effort, and costs far outweigh the total claim involved and fighting it out would just result in a Pyrrhic victory.
This notwithstanding, a claimant still has the means to seek redress of his or her grievance without immediately resorting to courts of law. For insurance claims involving nominal amounts, claimants may initiate a complaint directly with the Insurance Commission under Insurance Memorandum Circular 2016-01, also known as the Rules of Procedure for Small Claims Cases in the Insurance Commission. Worth noting is that pursuant to IMC 2020-01, the Rules of Procedure for small claims now covers insurance claims not exceeding P400,000 (originally P200,000), exclusive of interest, costs, and attorney’s fees.
Here, the process is simple. A complaint may be commenced by accomplishing a verified Statement of Claim, a form provided by the Insurance Commission, and attaching the necessary documents such as the notice and denial of the claim, affidavits of witnesses if there are any, and other pieces of evidence subject of the claim.
Alternatively, the claimant may seek the assistance of a lawyer in preparing a verified complaint with a Certificate of Non-Forum Shopping. This is an option that may be considered especially when the claim is grounded on issues or matters that involve legal intricacies a layperson may have difficulty understanding.
Note, however, that under the IMC, the appearance of lawyers is prohibited. Nevertheless, in cases where the hearing officer determines that a party is unable to effectively present his or her case, another person who is not a lawyer may be allowed to assist that party.
The complainant also has the option to join in a single action two or more small claims against the insurer provided that the total amount claimed, exclusive of interests and other costs, does not exceed the P400,000 threshold.
During the hearing before the Insurance Commission, the Hearing Officer will first endeavor to have the parties settle their dispute amicably. Any amicable settlement reached by the parties shall be reduced into writing and signed by them. This will then be sent to the Division Manager for approval.
In instances where no settlement is reached, the hearing will then proceed informally and shall be terminated within five 5 hearing days. The decision of the Commission is rendered within 30 days from the date of last hearing.
This decision is already final and unappealable. Upon motion, a Pre-Execution Conference shall be set by the Hearing Officer and an order of execution and satisfaction of judgment shall be issued.
The filing of claims for nominal amounts before the Insurance Commission is an avenue worth considering. It offers a simpler and more expedient means that only requires the relatively informal participation of the parties. Accordingly, the cases are more swiftly resolved, allowing the insured to better focus on rebuilding what was lost.
