The Insurance Ombudsman Association

Here you will find interesting information about the organization of the Versicherungsombudsmann e. V., the arbitration board and proceedings and how to submit a complaint 

1. The Insurance Ombudsman Association
The activity of the Insurance Ombudsman association started in 2001. That year the board of trustees was founded. As a registered association it is a legal person and therefore has legal capacity. Respectively the association has its own organization and is institutionally independent.

The association is based in Berlin, along with the head office and the office of the Ombudsman respectively Ombudswoman.

The purpose of the association is the promotion of out of court dispute settlement with consumers, especially regarding insurance contracts or the procurement of those. Members of the association are insurance companies and the German Insurance Federation (GDV). They support and finance the arbitration board. About 300 members belong to the association. The organs of the Versicherungsombudsmann e V. are the board of directors and the general meeting. In addition, there is an advisory board, which is of great importance as an expression and guarantor of the independence of the Ombudsman. The committee consists of representatives of the following groups: Consumer organisations, member companies, insurance supervisors, academics, parliamentary fractions and insurance agents. Its tasks, which are within the law of the Statutes, include the appointment of the Ombudsman and to participate in amendments of the code of procedures. A further function of the committee is to accompany and advise on the work of the Ombudsperson.

2. Arbitration board
The arbitration board consists of the elected Ombudswoman and staff, who support the board in its activity. More than 45 people help to settle disputes, among them legal experts, insurance clerks and administration employees as well as office assistants.

The Versicherungsombudsmann e. V. has two jurisdictions that are based on different principles:

  1. Complaints against insurance companies, who are members of the association and have equipped the Versicherungsombudmann e. V. with certain powers
  2. Complaints against insurance agents according to a statutory rule.

This applies to all classes of insurance except for private health and nursing care insurance.

The Versicherungsombudsmann e. V. (association Insurance Ombudsman) is a state-approved consumer arbitration board.

3. The Ombudswoman in person
Since April 2024 Dr. Sibylle Kessal-Wulf is the Insurance Ombudswoman.

She was entrusted with various tasks in the judiciary for many years e. g. as a district judge in Flensburg for civil law and criminal law. Afterwards she worked for 10 years at the Schleswig-Holsteinische Higher Reginal Court in Schleswig in a senate for banking and corporate law. From 2001 to 2011 she was a member of the Senate for Insurance and Inheritance Law of the Federal Court of Justice. In February 2011 she was appointed Chairwoman of the Senate at the Federal Court of Justice. From the end of 2011 to the end of 2023 she was a member of the Second Senate of the Federal Constitutional Court. Dr. Kessal-Wulf is free in her official duties and is not subject to any instructions.

4. Proceedings

  1. a) General Information
    Complainants may have themselves represented within the limits of law by for example a relative, friend or lawyer. The proceedings are free of charge, except for own expenses as for example postage or for the representative. You should not wait too long before filing the complaint as the enforcement of a claim may already fail due to statutory limitation. Therefore, the Ombudswoman should be involved as soon as possible after claiming at the insurance company or the insurance agent. Complainants do not need to accept the decision of the Ombudswoman but may go to court any time.
  2. b) How can the Ombudswoman help?
    The Ombudswoman handles difficulties of the insurance customers, non-bureaucratically. She must look at the complaint impartially and has to judge only on the basis of the facts. In doing so, she applies the same standard as a court: legal rules and regulations. If the Ombudswoman ascertains that the claim is not legally justified, she will explain the contexts generally in plain language and without the typical “insurance language”. Complainants get an overview about their legal situation and may consider whether for example they wish to pursue their claim further in court. Of course, the dispute resolution proceedings do not lead to any disadvantages – all legal remedies can be used without any further effect. The Ombudswoman may decide only on a distinct basis. If the parties describe the facts differently and if witnesses should be heard, the written dispute resolution reaches its limits. It is not uncommon to conclude the dispute by mutual settlement. A settlement requires that both parties agree. The Ombudswoman is neutral and impartial. Therefore, she cannot represent consumers like a lawyer, who only has to consider the interests of his client. The Ombudswoman will, however, ensure a fair trial. The Ombudswoman cannot give legal advice, neither on insurance matters nor on financial matters. Her task is to settle disputes. Please note that the language of the Versicherungsombudsmann e. V. is German. Therefore, the complainants themselves have to make sure that they submit their concerns to the association Insurance Ombudsman correctly and completely. The Ombudswoman writes her decision and the relevant documents in German. Occasionally, it is possible to translate the essence into English without obligation.
  3. c)The most important differences between both tasks
    1. aa) Proceeding against insurance companies
      First of all the Ombudswoman is responsible for complaints of consumers concerning an insurance contract. If the proceedings end with a decision against the insurer, the latter must comply if the value of the complaint does not exceed EUR 10,000. If the value is above this, the decision is also non-binding for the insurer. According to experience, however, insurers usually also follow the Ombudswoman's view.
      If the Ombudswoman ascertains that the insurer has handled the case correctly or has already provided adequate compensation, she will explain the legal context in a comprehensible way.
      Claims against the insurer do not expire during the proceedings.
    2. bb) Proceedings against insurance agents
      The Ombudswoman is only concerned with claims, if

      • they concern procurement of an insurance contract,
      • the complainant is policyholder; and
      • they concern an insurance agent or broker

      The insurance agent does not have to adhere to the decision of the Ombudswoman. The law, on which the proceedings are based, does not provide any handle. The complainants must pay attention to the limitation period of the claims in the proceedings against insurance brokers themselves.  The statute of limitations does not suspend the limitation of any claims. Maybe a legal regulation intervenes.

  4. d) Which information and documents are important?
      1. personal details of the policyholder,
      2. copies of relevant correspondence
      3. aim to be achieved with the complaint (e. g. payment of a certain amount of money, rescission of contract)

    and, if not already included,

      1. a brief description of the facts,
      2. name of the insurer or the intermediary, insurer's certificate or claim number,
      3. other documents (e. g. expert opinions, cost estimates, repair invoices).
  • e) How to submit a complaint
    The complaint may be submitted online only in German. There is also the possibility to download an English form here. Please print out the pdf, fill it in and send us the signed version by mail or fax. The staff of the arbitration board is glad to help. When calling, the documents should be kept available.
  • f) Legal information for complainants
    1. aa) General information
      The Versicherungsombudsmann e. V. is a consumer arbitration board approved by competent authorities. Therefore, proceedings are ruled by the Consumer Dispute Settlement Act. Therefore, the involved parties are to be informed of the following facts: Usually, the code of procedure of the Versicherungsombudsmann e. V. (VomVO) applies to the proceedings. If the claim is directed against an intermediary personally, the code of procedure for complaints concerning procurement of insurance contracts (VermVO) may be applied. Both codes of procedure may be viewed on our website or may be sent to you on request. By participating in the proceedings, you agree to the respective regulation.The conclusion of dispute settlement proceedings may differ from the result of judicial proceedings. . The staff of the Versicherungsombudsmann e. V. will assist you in submitting the complaint. Our staff helps to formulate the aim of the complaint and provide information on the documents and information needed. The parties to the proceedings may advise someone, on their own expenses, who is legally authorised to represent and / or counsel them. However, this is not necessary. At any time, you may withdraw the application for dispute resolution or object to the further execution of the proceedings. Then the proceedings end with the receipt of the statement by the Ombudswoman. The proceedings are free of charge for the complainant. Only own costs are incurred, such as postage. In exceptional cases, a misuse fee may be required. The Ombudswoman treats all information strictly confidential. Personal data is not passed on to third parties but is exclusively recorded and used for the purpose of handling the complaint. If necessary, for the examination of the claim, the Ombudswoman will pass on the documents to the opponent of the complaint. In the contrary, usually, she is passing on to you documents of the opponent as well. The principle of the right to be heard is respected.
    2. bb) Important information about the legal consequences of a settlement
      With conciliation you enforce part of your position, the other part is abandoned. However, this also applies to the other party. The whole purpose of conciliation is to settle the dispute by mutual agreement.Conciliation is considered if the facts or the legal assessments are ambiguous. Thus, conclusion of legal proceedings is uncertain. Conciliation may be used to end the dispute, thus saving time and money, as well as avoiding the risk of judicial defeat. Both sides must keep to conciliation. If new insights arise, the settlement cannot simply be reversed. Conciliation may differ from the result of court proceedings, both positive and negative. Only you decide on accepting a conciliatory proposal. Of course, you may reject the proposal and go to court.