Claims service of the General Directorate of Insurance and Pension Funds

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The Claims Service of the General Directorate of Insurance and Pension Funds (SRDGSFP) is the department responsible for resolving complaints and claims raised by users of insurance services and the Pension Plan in Spain.

It is a department created in 1964 in order to resolve the disagreements raised by the insured, participants and beneficiaries of insurance and the Pension Plan. In this sense, any user who considers that their rights have been violated as a result of the inefficient action of an entity may go to the Claims Service of the General Directorate of Insurance and Pension Funds.

In fact, you can also go to the Complaints Services of the National Securities Market Commission (CNMV) and the Bank of Spain. Any of the three departments will analyze its content and forward the complaint in case of incompetence to the appropriate department. However, it should be noted that their reports are not binding but merely informative.

The DGSFP is in charge of establishing the necessary requirements to be able to present claims and causes of inadmissibility. In addition, annually the report of the Complaints Service of the DGSFP is published where the complaints of the users, the resolution adopted and the subsequent position of the entities, acting or not acting accordingly, are summarized.

Who can make a claim before the Claims Service of the General Directorate of Insurance and Pension Funds?

In accordance with the provisions of the regulations, any person who has the status of:

  • Natural or legal persons of Spanish or foreign nationality (in their own interest or that of the client):
  • Policyholder
  • Insured
  • Insurance beneficiary
  • Third party injured
  • Participant in a pension plan
  • Beneficiary of a pension plan
  • Insurance or plan beneficiary
  • Associations that represent the collective interests of users.
  • Customer service departments (usually inquiries).

In addition, said services must have been provided by one of the entities supervised by the DGSFP. That is, by entities that have the status of authorized entities:

  • Insurance and reinsurance entities
  • Pension fund management companies
  • Insurance intermediary companies and reinsurance brokers
  • Depository entities of pension funds
  • Credit institutions (if they market insurance, pension plans or act as depositories of the latter).

The investor can consult in the public records of the DGSFP which entities are expressly unauthorized.

Claim object before the Claims Service of the General Directorate of Insurance and Pension Funds

The legitimized user has three ways to start the process with the DGSFP: Queries, complaints and claims. In all three cases, the object of the procedure must be related to the impairment of the rights acquired by the user when entering into a contract with the entity or to the violation of the regulations on customer protection and information transparency:

  • Consultations: In relation to procedural issues and interpretation of the regulations.
  • Claims: For actions or omissions of the entities in breach of the regulations and in which a right or interest of the user tries to be restored.
  • Complaints: Due to inefficient actions of the entities (delays, neglect, etc).

Procedure to follow before the Claims Service of the General Directorate of Insurance and Pension Funds

It is regulated in ECC Order 2502/2012, of November 16, and consists of several steps: First, the user must file the claim with the entity's Customer Service Department. Also, if the entity has this figure, the defender of the insured or the participant. If the petition is rejected or a period of two months has elapsed since its presentation without obtaining a resolution, the client must formally file their complaints with the SRDGSFP. Second, the user must prepare all the documentation required to start the procedures with the DGSFP. Finally, the claim will be carried out through one of the planned channels (in person or online).

Regarding the processing of claims, if it is admitted, the information is transferred to the claimed entity so that it can provide allegations. The procedure may end prior to the resolution of the DGSFP due to the search of the entity or the withdrawal of the interested party or after the issuance of the resolution report. However, obtaining a favorable resolution does not mean that the user will see their claims restored. Remember that the reports issued by the DGSFP are not binding.

Other departments responsible for resolving complaints and claims:

  • Market Conduct and Claims Department of the Bank of Spain.
  • Complaints service of the National Securities Market Commission (CNMV).

Order ECC / 2502/2012, of November 16, includes the common procedure for filing claims before any of these three departments.

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