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Article (101): Claims and Settlement of Insurance Claims

1)

The Company shall process Insurance Claims in accordance with the provisions of the Insurance Policies and the legislation in force, by applying the following procedures:

  

a.

Issuing a decision on any Insurance Claim, in accordance with the directives of the rules of professional practice and ethics.

  

b.

In the event that any Insurance Claim is rejected, in whole or in part, the Company shall state the reasons for its decision in writing.

2)

If a dispute arises out over an Insurance Claim or if the stakeholder objects to the clarifications provided by the Company, the stakeholder may file a complaint to the Banking and Insurance Dispute Settlement Unit, established pursuant to Article (121) of Federal Decree-Law No.(14) of 2018, referred to hereinabove.

3)

A complaint shall be filed according to the procedures approved by the Banking and Insurance Disputes Settlement Unit.

4)

One or more committees shall be established in the Banking and Insurance Disputes Settlement Unit to settle disputes arising from insurance contracts, insurance business and services. The Board shall issue the necessary decisions determining its competences, powers, rules of procedure, remunerations of its members and the fees it collects, in addition to the decisions related to its formation. The committee shall be headed by a judge with one or more judges selected the by CBUAE as members.

5)

The Company may not challenge the decisions of the committee referred to in Clause (4) above on disputes whose value does not exceed (AED 50,000) fifty thousand dirhams. Such decisions shall be final and enforceable immediately upon their issuance. If the dispute value exceeds (AED 50,000) fifty thousand dirhams, the Company may challenge the committee’s decisions before the Court of Appeal within (30) days, from the date of its issuance or knowledge thereof, otherwise, the challenge shall be inadmissible.

6)

Without prejudice to the provisions of Clause (5) above, the concerned party may challenge the decisions of the committee referred to in Clause (4) above before the Court of Appeal, within (30) days from the date of issuance of the decision or knowledge thereof; otherwise, the challenge shall be inadmissible.

7)

Cases arising from insurance contracts, business and services shall be inadmissible if they are not submitted to the committees formed in accordance with the provisions of Clause (4) above.

8)

The committee’s decisions shall have the force of a writ of execution, and a challenge shall stay the execution of a decision on disputes whose value exceeds (AED 50,000) fifty thousand dirhams.