Clarification regarding the establishment of material and moral compensation for claim files relating to bodily damages or death, with reference to insurance companies undergoing winding-up procedures

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  • Clarification regarding the establishment of material and moral compensation for claim files relating to bodily damages or death, with reference to insurance companies undergoing winding-up procedures

Following the publication in mass-media of a material which challenges the manner of granting compensation in cases of payment requests relating to claim files on bodily damages or death, with reference to insurance companies undergoing winding-up procedures, the FGA makes the following statements:

FGA makes use of the “Procedure for the amicable settling of monetary claims (material and moral), born out of bodily damages cases or death”, which is an internal procedure regulating FGA’s criteria for determining values thresholds.

The criteria has been established for the purpose of avoiding discrimination in such a sensitive topic, where there are no legal criteria for individualizing amounts due, considering that FGA manages funds that require a significant degree of responsibility.

Compensation due to insurance creditors, following bodily damages or death, is calculated keeping in mind the aforementioned Procedure, as well as jurisprudence on the matter and the common practice of insurance companies.

The internal Procedure includes criteria for determining moral compensation in case of bodily damages, as well as value thresholds according to the gravity of the damage and the number of days for medical care.

In cases where moral compensation is required following death, the determination of value of compensation is made considering average values provided by the Guide issued by Street’s Victims Protection Fund, taking into account the family degree of the claimant with the deceased person.

At the time of analyzing payment requests of claimants, compensation is determined in a manner that will not lead to an unjustified allocation of sums. Moral compensation is determined taking into account the specific circumstances of the occurred events.

Following the settlement of the payment requests of claimants, a Decision will be issued, in case of rejection in part or in whole of the amounts requested. The Decision is an administrative act pursuant of art. 2 para (1), let. c) of Law no. 554/2004. This Decision can be challenged at the Fiscal and Administrative Contentious Court within the Bucharest Court of Appeal, as the specialized Court entitled to settle a challenge against the FGA decision. As such, the free access to justice is in no way prevented, pursuant to art. 13 para (5) of Law no. 213/2015.

We emphasize that the FGA is a legal person of public law, pursuant to art. 1 of Law no. 213/2015.

The regulation of internal administrative procedures and utilizing the financial resources of the Fund, as well as the procedure and requirements for effecting payments from its available assets, are made pursuant to Law no. 213/2015, as well as pursuant to FSA Norm no.16/2015, both in force at the date of adoption of the internal Procedure challenged through mass-media.

Pursuant to art. 26 of Law no. 213/2015, the Fund is managed by the General Manager who can issue operational decisions for organizing and managing the ongoing activity of the Fund, including for internal procedures and operational instructions that relate to the manner of settlement of payment requests and handling of claim files.

The judicial practice so far is, in majority, favourable to the Fund, meaning that the Courts of law considered that the Fund took into account objective and reasonable criteria, as included in the “Procedure for the amicable settling of monetary claims (material and moral), born out of bodily damages cases or death”.

Fondul de Garantare a Asiguraților

s-a constituit ca persoană juridică de drept public conform Legii nr. 213/2015 privind Fondul de Garantare a Asiguraților

București, Romania