The most practical way to process small insurance claims

IN the previous column, we started discussing how the Insurance Commission ( IC) may preside over settlement on disputes or disagreements on insurance claims.

It was emphasized that if the money claim is less than P5 million, the insuring public need not go through the formal legal process which involves a longer time frame and entails more cost. In fact, the claims process may

- mal complaint, free of charge, through the Public Assistance and Mediation Division (PAMD) of the IC, which will then facilitate a mediation conference.

If no agreement or settlement is reached between the complaining policyholder or

insurer that denied the former’s claim, the complainant has the

complaint against the insurer through Claims and Adjudication Division (CAD) of the IC.

smaller amounts or those cases where the claims amount to

exclusive of interest, attorney’s fees and costs.

The rules and procedure for small claims cases are found in the IC’s Memorandum Circular 20161, otherwise known as the Rules of Procedure for Small Claims cases in the Insurance Commission.

How is the ‘small claims’ process quicker and cheaper than the IC’s regular formal complaint procedure?

One of its main features is the set of IC-approved forms or template documents that only need to -

of non- forum shopping ( Form 1-A-IC), and other important and relevant documents.

For small claims, the complainant may also join in a single statement of claim along with one or more separate small claims against the same insurance company, which will allow the IC to reduce the claims process time.

Upon determination by the hearing officer or the division manager of the IC’s CAD that the case is to be considered as “small claims,” the Insurance Commissioner, based on the statement of claim and evidence attached to it, may order the dismissal of the Since the case involves only small claims, instead of submitting

the help of a lawyer, the respondent can submit a

and attach other relevant documents.

Once more, this IC-approved form allows for a faster and cheaper process, although the respondent is not prevented from submitting a verified response prepared by a lawyer.

The “small claims” proceedings also prohibit several pleadings, motions, or petitions, which are done under the regular claims process.

This prohibition furthers the purpose of providing a faster and less expensive claims process for smaller claims.

It is also noteworthy to point out that in the small claims process, unless the lawyer is the complainant.

the complainant cannot represent himself properly, he may allow another individual who is not a lawyer to assist him in defending his case.

Thus, it is crucial that the parties in the case appear during the hearing of the case. Failure to do so will lead to the automatic dismissal of the claim or counter-claim.

This prohibition further simplifies and makes the claims process less expensive.

claims’ case does not have to be the Insurance Commissioner.

The CAD division manager may lead the hearing which speeds up the process given the busy schedule of the Commissioner.

Lastly, the decision of the commission in small claims cases is issued 30 days after the last

unappealable, further decreasing the process time.