The Ombudsman for insurance in Belgium
The Ombudsman for insurance is the Belgian body that examines disputes between a consumer and an insurance company or intermediary, free of charge. It intervenes after you have tried to resolve the matter directly with the company. Its opinion is not binding.
The disputes it examines
A refusal to intervene after a claim, a compensation considered insufficient, or a guarantee applied differently from what you understood you had bought.
Disputes about a contract itself: a cancellation not taken into account, a premium increase applied outside what the contract allows, a policy terminated without a ground you can identify.
And disputes with an intermediary — broker or agent — about the advice given, the information provided, or the handling of your file.
The prior step is indispensable
Write to the company's own complaints service first and keep the reference. The Ombudsman's role begins where the internal route has failed.
Ask for the written reasons for any refusal, with the clauses relied on. Without that document, any remedy starts from a much weaker position.
Then assemble the file: the general and particular conditions, the declaration, the correspondence, the expert's report. Insurance disputes are decided on documents.
How it proceeds and what the opinion is worth
The examination is written and free. The Ombudsman can ask the company for explanations and for the documents on which it relied.
It issues an opinion. That opinion does not bind the company, although companies follow it in a substantial share of cases and a reasoned opinion carries weight in any later step.
If the matter goes no further, the ordinary courts remain available. For most consumer files the Ombudsman route resolves it or clarifies it enough to decide.
Do not confuse the bodies
The Ombudsman settles individual disputes between you and a company or an intermediary. That is the route for a refused claim.
The FSMA supervises the sector, the conduct rules and the register of intermediaries. It does not compensate you and does not settle your individual file.
Writing to the wrong one costs weeks. For a claim that was refused, the Ombudsman is the address.
Frequently asked questions
Does applying to the Ombudsman cost anything?
No. The examination is free and written, and it is open to consumers in dispute with an insurance company or an intermediary. It does not require a lawyer.
Must I write to my insurer first?
Yes. The Ombudsman's role begins where the company's own complaints service has failed, so raise the matter internally first and keep the reference. Ask at the same time for the written reasons for any refusal.
Is the insurer obliged to follow the opinion?
No. The Ombudsman issues an opinion rather than a judgment, and it does not bind the company — though companies follow it in a substantial share of cases and a reasoned opinion carries weight in any later step.
How is this different from the FSMA?
The FSMA supervises the sector, the conduct rules and the register of intermediaries; it does not compensate you or settle your individual file. For a refused claim, the Ombudsman is the correct address.