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European Insurance and Occupational Pensions Authority
 

3219

Q&A

Question ID: 3219

Regulation Reference: (EU) No 2016/97 - Insurance Distribution Directive

Topic: Definitions (Art. 2 IDD)

Article: 2(1)(1)

Status: Rejected

Date of submission: 31 Dec 2024

Question

Can an insurance broker (including a captive broker) who has a legal authorization only for an insurance broker (the distribution of insurance) or reinsurance, carry out the activity of claims management, as well as the activities of instruction and assessment of claims otherwise carried out by the insurer, given that these claims fall under the Professional Civil Liability guarantee of the clients of said broker (and the broker and his clients are in "close ties" in the case of a captive broker)?

In addition to these practices violating the principle that all policyholders and beneficiaries should receive equal treatment, in the event of an amicable claim by a third-party beneficiary who is entitled to compensation for RC Pro, these activities are in violation of:

COMMISSION DELEGATED REGULATION (EU) 2015/35 of 10 October 2014 supplementing Directive 2009/138/EC of the European Parliament and of the Council on the taking-up and pursuit of the business of Insurance and Reinsurance (Solvency II).

Article 274 -1, 3, 3 (a) concerning a legal authorisation and (b) the service provider has taken all necessary measures to ensure that no manifest or potential conflict of interest compromises the satisfaction of the needs of the subcontracting company;

DIRECTIVE (EU) 2016/97 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL

of 20 January 2016

on insurance distribution

Article 2(2)

For the purposes of points (1) and (2) of paragraph 1, none of the following activities shall be considered insurance or reinsurance distribution:

(b) the professional management of claims by an insurance or reinsurance undertaking and the activities of assessment and settlement of claims

DIRECTIVE 2009/138/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL

of 25 November 2009

on the taking-up and pursuit of the business of Insurance and Reinsurance (Solvency II)

(8) Access to the business of insurance and reinsurance should be subject to prior authorisation. It is therefore necessary to lay down the conditions and the procedure for granting such authorisation and for refusing it.

(105) All policyholders and beneficiaries should receive equal treatment,

Article 13

2) ‘captive insurance undertaking’:

17) ‘close links’

Article 19

Close links

Where close links exist between the insurance or reinsurance undertaking and other natural or legal persons, the supervisory authorities shall grant authorisation only if those links do not hinder the proper exercise of their supervisory duties.

Art 24

Shareholders and members with a qualifying holding

1. The supervisory authorities of the home Member State shall not grant authorisation to an undertaking to take up the business of insurance or reinsurance before having obtained the identity of the shareholders or members, whether direct or indirect, whether natural or legal persons, who have a qualifying holding in it, and the amount of that holding.

Art 49

Subcontracting

1. Member States shall ensure that insurance and reinsurance undertakings retain full responsibility for compliance with all their obligations under this Directive when they subcontract insurance or reinsurance functions or activities.

2. The subcontracting of important or critical operational activities or functions shall not be carried out in a manner likely to have any of the following consequences:

(a) seriously jeopardise the quality of the system of governance of the undertaking concerned;

(b) unduly increase operational risk;

(c) jeopardise the ability of supervisory authorities to verify compliance by the undertaking concerned;

(d) impair the continued provision of a satisfactory level of service to policyholders.

3. Insurance and reinsurance undertakings shall inform

the supervisory authorities in advance and in good time of their intention to outsource important or critical activities or functions, as well as of any subsequent significant developments concerning these functions or activities.

Minimum capital requirement

Art 128 and Art 129

i) of EUR 2 200 000

 

Finally, in terms of identifying conflicts of interest, in accordance with Article 3(2)(a) of Commission Delegated Regulation (EU) 2017/2359, intermediaries and insurance undertakings must take into account different situations such as: "the insurance intermediary or the insurance undertaking, a relevant person or any person directly or indirectly linked to them by a control relationship is likely to make a financial gain or avoid a financial loss to the potential detriment of the client".

EIOPA answer

This question has been rejected because the issue it deals with is already explained or addressed in Article 2(1)(1) of IDD. 

Article 2(1)(1) of IDD states that “insurance distribution’ means the activities of advising on, proposing, or carrying out other work preparatory to the conclusion of contracts of insurance, of concluding such contracts, or of assisting in the administration and performance of such contracts, in particular in the event of a claim”. In addition, recital 14 of the IDD states that “this Directive should not apply to the professional management of claims on behalf of an insurance or reinsurance undertaking, nor to the loss adjusting and expert appraisal of claims”.

In this light, a registered intermediary (in our example a broker) cannot do on a full-time basis a claims management activity. The broker can only provide assistance for managing claims.