Question ID: 3369
Regulation Reference: (EU) No 2016/97 - Insurance Distribution Directive, (EU) No 2009/138 - Solvency II Directive (Insurance and Reinsurance)
Topic: Competences of home and host Member States (Art. 7 - 9 IDD), Complaints and Out-of-court redress (Art. 14 and Art. 15 IDD)
Article: Article 30 of Directive 2009/138/EC (Solvency II), Articles 7, 14, 15 of the Insurance Distribution Directive (EU) 2016/97 (IDD), Article 183 of Directive 2009/138/EC (Solvency II)).
Status: Question forwarded to the European Commission
Date of submission: 20 Jun 2025
Question
Where can insured persons covered under a group insurance contract governed by the law of a host Member State but - and whose habitual residence can be in a different country – file a complaint against the insurer/intermediary under the contract? What complaints mechanism is available to those insured persons? Will it be the local complaints mechanism/Ombudsman in the home country or the host Member State of the insurer/intermediary?
Background of the question
The aim is to seek clarification regarding the rights of insured persons under group insurance contracts concluded by a legal entity, where: (i) the insurer is authorised and supervised in its home Member State. (ii) The policyholder is based in another Member State, and the contract is governed by that host Member State’s law. (iii) The insured persons are natural persons located worldwide, including both within and outside the EEA. In particular, we would appreciate EIOPA’s guidance on: • Whether insured persons who reside outside the host Member State but are covered under a contract governed by its law, have the right to: (i) file a complaint with the home Member State Ombudsman; or (ii) should instead the host Member State’s authority or Ombudsman based on the applicable law. • How EIOPA interprets the interaction between: the applicable law of the contract, the supervisory authority of the insurers, and the geographical location of the insured persons