European Commission

 

Case detail

Directive article National ID Ombudsman of the Consumer 16th of December 2009 (Protocol No 3990)
Country Greece Decision date 16/12/2009
Common name Decision type Other
Court Συνήγορος του καταναλωτή Plaintiff(s) Consumer
Court translation Ombudsman of the Consumer Defendant(s) Commercial Value
Subject misleading omissions
Keywords average consumerinsurance policymisleading omissionstransactional decision

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Headnote

An average consumer cannot be expected to know that an insurance company's liability for a vehicle's own damage is calculated in such way that any amount paid during each insurance period is subtracted from the insured amount. Omitting to provide such essential information is unfair, as it probably leads the consumer to take a transactional decision that he would not have taken otherwise.

Facts

A consumer had submitted a complaint to the Ombudsman of the Consumer claiming that the defendant (an insurance company) denied paying the amount of 2.475 EUR regarding submitted invoices for the repair of his vehicle after an accident. The consumer argued that the insurance contract signed by the parties, which was valid at the time of the accident, included -- among others -- the coverage of the vehicle’s own damages.

The insurance company argued that for a vehicle’s own damages, the insurance company’s liability was limited to the insurance amount that existed at the day of the damage. From this amount, any amount paid during each insurance period was removed, so that only the rest remained as the insured amount. For this reason, the insurance company argued that the consumer was entitled to only 321 EUR.

Legal issue

Can an average consumer be expected to know that an insurance company's liability for a vehicle's own damage is calculated in such way that any amount paid during each insurance period is subtracted from the insured amount?  

Decision

According to the decision, the omission of the insurance company to provide the consumer with the information required to take a transactional decision, constitutes an unfair commercial practice.

The special calculation rule requires a specialised knowledge for the average consumer. Proper professional diligence and deontology requires an insurance company to notify the consumer about the application of the rule, by explaining the financial parameters that would affect the consumer. By omitting to provide information on this specific dimension of the insurance relationship, the consumer’s choice was probably directed towards a transactional decision that he would have not taken otherwise.

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Result

The Ombudsman recommended the insurance company to pay the remaining amounts, based on the invoices.

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