The Insurance and Social Security Supervisory Authority (ACAPS) has set out new procedures for handling claims related to death insurance contracts in a move to strengthen transparency and beneficiary protection.
This initiative, which is part of a drive to increase accountability among industry players, aims to standardise practices, minimise disputes and strengthen beneficiary rights through a structured and documented claims process.
The new directive is aimed at all insurance and reinsurance companies that have until 1 July 2025 to comply with these new procedures.
Insurers and reinsurers are therefore required to implement formal and transparent internal procedures governing the processing of claims, from the filing of the claim to its settlement, and specifying the deadline for each stage. This includes informing the claimant (beneficiary) of the procedures for processing the claim, specifying the time required to process their claim and the progress of their file. In the event of rejection of compensation claims, the insurance company concerned must provide the reasons therefor while specifying possible appeal procedures.
Supporting documents
The ACAPS instruction specifies that companies must remind the claimant of all the supporting documents to be produced when reporting a claim, as specified in the death insurance contract. (Re)insurers must clearly and precisely list all the documents referred to in the contract, to avoid any confusion or omission in the reporting process. This obligation aims to simplify the procedure for beneficiaries and to ensure that all necessary information is provided at the outset.
In addition, the companies may request additional documents not mentioned in the insurance policy but which are necessary for the examination of the claim and the payment of compensation or benefits. This allows insurers to adapt to exceptional situations while ensuring that the rights of beneficiaries are respected.
ACAPS emphasises that the production of the required documents should not constitute an obstacle for beneficiaries. The aim is to avoid any unjustified administrative complexity and to ensure that beneficiaries can access their compensation within a reasonable timeframe.