Complaints Management Policy (Utmost Luxembourg)

1. INTRODUCTION

1.1 Purpose/background of the Policy

On 14 June 2012, the European Insurance and Occupational Pensions Authority (EIOPA) issued the “Guidelines on Complaints-Handling by the Insurance Undertakings” which require that a “Complaints management policy” is put in place by the insurance undertakings ( the “EIOPA Guidelines”). On 21 December 2012, the Luxembourg insurance regulator, the Commissariat aux Assurances (CAA), informed EIOPA that it would fully apply the EIOPA Guidelines and on 7 January 2014, the Circular Letter 14/1 was issued by CAA ( the “Circular Letter”). According to the Circular Letter, the EIOPA Guidelines are to be considered as minimum standards for complaints handling.

On 26 February 2019, the CAA issued Regulation No. 19/03 relating to out- of- court complaint resolution (the “2019 Regulation”).

This complaints management policy (the “Policy”) is intended to ensure that the Company handles complaints fairly, efficiently and effectively. it also provides guidance to our employees, partners, and people who wish to make a Complaint.

For the purposes of this Policy, the words and expressions set out below shall have the following meanings:

• “Complainant” means a person who is presumed to be eligible to have a Complaint considered by an insurance undertaking and has already lodged a Complaint e.g., a policyholder, insured person, beneficiary and, in some jurisdictions, injured third party.
• “Company” means Utmost Luxembourg S.A., including its branches.
• “Complaint” means a written dissatisfaction addressed to the Company on a dysfunction of the latter which is not resolved by the agreement of both Complainant and the Company no later than the first working day following the receipt of the Complaint.

Specifically, a dysfunction relates either to:

• The Company’s overall organisation;
• The insurance contract; or
• The insurance service the Company has provided or failed to provide.

It is therefore not regarded as a Complaint if it concerns:

• A simple request for execution of the insurance contract;
• A request for the provision of a service;
• A simple request for information or clarification;
• A grievance resolved no later than the first working day following its receipt, provided the Company’s
• proposed solution has been accepted by the Complainant; and
• A Complaint received by the Company concerning activities other than those regulated or related to another entity for which it has no competence.

1.2 Administration of the Policy

As per the Utmost Group Policy Framework, the Risk Oversight Committee (ROC) has the final authority to approve this Policy. The Chief Operating Officer is responsible for the Complaints-handling process of the Company. This corporate Policy will be reviewed annually or when major changes occur.

2. POLICY STATEMENT

2.1 Basic Principles

The basic principles that are appropriate to the Company are the following:

• Visibility and accessibility;
• Fairness and objectivity / customer-focused approach;
• A single point of contact for all Complaints;
• Rigorous standards for response and resolution;
• Accountability; and
• Continuous improvement.

2.2 Process for Complainant

2.2.1 The single point of contact for all Complaints is the Partner & Client Services Department (PCS).

A Complaint may be addressed to the Company in writing. The Complainant shall explain in detail the facts behind the Complaint and provide all relevant supporting documentation.

To facilitate the interaction between the Complainant and the Company, any Complaint shall be addressed to and will be managed by the relevant PCS desk and shall contain at least the following information:

• Name, first name, address and details of the Complainant;
• Role of the Complainant (policyholder, life assured, beneficiary, partner, …);
• Policy number (where applicable); and
• Clear and detailed description of the Complaint.

Complaints can also be forwarded to the Company by the Complainant’s intermediary.

2.2.2 Complaints received by the Italian branch of the Company (the Italian Branch)

The Company:

• Has established a complaint function within the Italian Branch aimed at assuring that Complaints received by the Italian Branch are investigated fairly and in compliance with the applicable laws and regulations (the Function); and
• Has appointed a senior manager responsible for the Complaints-handling process of the Italian Branch (Complaints Officer).

The Function will operate in compliance with the applicable provisions of the IVASS regulation no. 24 of May 2008 (Regulation 24), as amended by IVASS regulations no. 30 of March 2015 and no. 46 of May 2016.

The Complaints Officer will provide any information on Complaints handling to IVASS and will be in charge of managing the Complaints received by the Italian Branch.

In case of Complaints directly submitted to IVASS, the latter may require the Company to provide clarifications directly to the Complainant. In this scenario, the Complaints Officer shall send a copy of its reply to IVASS.

The Italian Branch notifies IVASS, within 10 working days from the relevant appointment, of the Function, the name of the Complaints Officer and the relevant contact details.

The Company guarantees the independence of the Function by adequately placing it within the organization and by envisaging appropriate procedures aimed at avoiding conflicts of interest with the structures or subjects whose behaviour is the object of the Complaint.

Moreover, the Italian Branch:

• Ensures the necessary internal flows of information and reporting lines for Complaints management, as appropriate; and
• Controls the effective and efficient treatment of Complaints, also considering this Policy.

2.2.2.1 Insurance Arbitration (for Italian policies only)

If the complainant is not satisfied or has not received a response from the Company within 45 days, they can refer the matter to the Insurance Arbitration (IA). The IA is an independent and impartial body that citizens and businesses can turn to in order to resolve insurance disputes.

Recourse to the Insurance Arbitrator must be made within twelve months of the complaint being sent to the Company.

If the IA’s decision is not satisfactory, both the policyholder and the company may appeal to the judicial authority.
Further information on submitting a complaint to the IA and its areas of competence can be found on the website https://www.arbitroassicurativo.it or by contacting IVASS.

2.2.3 Complaints received by the Belgian branch of the Company (the Belgian Branch)

Any Complaint received by the Belgian Branch will, by default, be handled by the Belgian Branch in accordance with the Complaints management procedure.

2.3 Internal process

All Complaints must be acknowledged and answered in accordance with the Complaints management procedure.

Upon receipt of a Complaint, PCS takes the following actions:

• Logs the Complaint within the Complaints’ Register;
• Performs an initial review of the Complaint within 2 working days of receipt;
• Acknowledges receipt of the Complaint to the Complainant within 10 business days of receipt; and
• Sends a detailed response to the Complainant within 30 days from the date of the receipt of the Complaint.

When an answer cannot be provided within 30 days, the Company shall inform the Complainant of the reason for the delay and indicate when the Company’s investigation is likely to be completed.

2.4 Rights of the Complainant

The Complainant has the following rights:

• The right to be informed about the Complaints management policy;
• The right to a fair, swift and comprehensive treatment;
• The right to receive updates regarding the progress, if any, in the handling of the Complaint;
• The right to be advised of alternative dispute resolution methods; and
• The right to be informed regarding the management of conflict of interests.

2.5 Conflict of interests

Internal procedures have been adopted to ensure that conflicts of interests are properly managed and effectively alleviated.

2.6 Escalation

2.6.1 Escalation to senior management

When the Complainant has not obtained a response, or the response received is unsatisfactory at the level to which they submitted the Complainant initially, the Complainant may escalate the Complaint to the Chief Operating Officer, Laurent Muguet.

2.6.2 Escalation to authorities

Without prejudice to any court action, if the response provided by the Company is not satisfactory to the Complainant, they may escalate the Complaint to the following authorities.

Escalation may also be addressed to other authorities in the Complainant’s country of residence. Please refer to the applicable general terms and conditions of your insurance contract for more information.

2.6.2.1 Out- of- court procedure with the CAA

The 2019 Regulation creates an out- of- court procedure allowing Complainant to escalate their Complaint to the CAA (the “Procedure”).

A request can be submitted to CAA only if:

• The formal Complaint has been submitted in writing to the Company and has not been answered, or has not been satisfactorily answered within 90 days;
• The request is admissible under article 4 of the 2019 Regulation; and
• The request to CAA is filed in Luxembourgish, German, French or English and includes the information required under article 5 (2) of the 2019 Regulation.

The CAA may request the production of additional documents or information it deems necessary. It will acknowledge receipt of the request within 10 business days and will transfer a copy to the Company, which shall respond within 30 days.

The CAA shall issue a reasoned conclusion within 90 days of receiving all necessary information. This period may be extended for highly complex cases, in which case the CAA will notify the Complainant and the Company.

The Complainant and the Company may be represented or assisted by a third party at any stage of the Procedure.

The Procedure is in writing, free of charge and its conclusions are not binding on either the Complainant or the Company.

More information on the Procedure can be found on the CAA website:

• English version: https://www.caa.lu/uploads/documents/files/RCAA_19-03_REL_EN.pdf
• French version: https://www.caa.lu/uploads/documents/files/RCAA_19-03.pdf

2.6.2.2 Other remedies

Médiateur en Assurances

c/o Association des Compagnies d’Assurances

12 rue Erasme, L-1468 Luxembourg-Kirchberg

Grand-Duché de Luxembourg; and/or

Union Luxembourgeoise des Consommateurs (ULC)

55, rue des Bruyères

L-1274 Howald.

2.6.2.3 Italian policies

For any Complaint related to an Italian policy, the Complainant may address the Complaint to the following authorities if the response provided by the Company is not satisfactory:

• For issues related to the insurance contract: IVASS (Italian Insurance Authority – Istituto per la Vigilanza sulle Assicurazioni) – Servizio Tutela degli Utenti, Via del Quirinale 21 – 00187 Rome, +39 06 42133745 or fax +39 06 42133353, certified email (PEC) [email protected];
• For issues related to informative transparency: CONSOB (Commissione Nazionale per le Società e la Borsa), Via G.B. Martini 3 – 00198 Rome.

For resolving cross-border disputes: the Complainant can submit a complaint to IVASS or activate the FIN-NET procedure (by accessing the website http://ec.europa.eu/internal_market/fin-net/members_en.htm).

The Complainant may also use alternative dispute resolution methods (ADRs) as set out in the general terms & conditions of the insurance contract and listed on the Company’s website under “Complaints management”, such as:

• Mediation procedure (pursuant to Legislative Decree n. 28 March 4, 2010,); and
• Assisted negotiation procedure (pursuant to Legislative Decree n. 132 September 12, 2014 turned into Law n. 162/2014).

The Complainant may also refer the matter to the Insurance Arbitration (pursuant to Ministerial Decree 215/2024) within IVASS (Italian Insurance Authority – Istituto per la Vigilanza sulle Assicurazioni) by activating the online procedure at https://www.arbitroassicurativo.it.

The Complainant is also entitled to contact: Commissariat aux Assurances at 7, boulevard Joseph II, L-1840 Luxembourg, https://www.caa.lu/fr/accueil; and Association des Compagnies d’Assurances (Service Médiation) at 12 rue Erasme, L -1468 Luxembourg, https://www.aca.lu/fr/mediateur-assurance. All of the above is without prejudice to any court action.

2.6.2.4 Arbitrator for Financial Disputes (only for insurance contracts issued by the Italian branch)

In addition to the methods listed above and in case of insurance contracts issued by the Italian branch, if the Complainant is not satisfied or has not received a response from the Company within 45 days, they may refer the matter to the Arbitrator for Financial Disputes (ACF).

The ACF is a system of extrajudicial resolution for disputes between investors and intermediaries on the infringement made by intermediaries of diligence, honesty and transparency duties including cross-border disputes and Regulation (EU) No 524/2013 disputes.

Important to note: ACF does not manage complaints involving sums greater than €500,000. For further information on how to submit a complaint to ACF and the scope of its competence, visit: https://www.acf.consob.it/ or contact Consob or the Italian branch. The right to submit a complaint to ACF cannot be waived by the investor.

2.6.2.5 Belgian branch

For any Complaint related to the Belgian Branch, the Complainant may submit the Complaint to the following authorities if the response provided by the Belgian Branch is not satisfactory:

Service de l’Ombudsman Assurances, at 35, square de Meeûs , B-1000 Bruxelles (www.ombudsman.as; tél: +32(2) 547 58 71, fax: +32(2) 547 59 75);

Financial Services and Markets Authority (FSMA) at Rue du Congrès 12-14, B-1000 Bruxelles, Belgique;
Commissariat aux Assurances at 7, boulevard Joseph II, L-1840 Luxembourg, https://www.caa.lu/fr/accueil;
Association des Compagnies d’Assurances (Service Médiation) at 12, rue Erasme, L -1468 Luxembourg, https://www.aca.lu/fr/mediateur-assurance
This without prejudice to any court action.

2.6.2.6 Portuguese market

If the Company’s internal Complaints management procedure has been completed and the issue has not been resolved in a satisfactory manner for the Complainant – either due to disagreement with the outcome or due to failure by the Company to reply within the applicable deadline, the Complainant may file a Complaint with the Company’s Ombudsman:

Mr. Tiago Caiado Guerreiro

Rua Castilho, 39, 15.º, 1250-068, Lisbon, Portugal

Email: [email protected]

The Complainant may also file a Complaint with the following authorities:

• Autoridade de Supervisão de Seguros e Fundos de Pensões, at Avenida da República, 76, 1600-205 Lisboa,www.asf.com.pt.
• Commissariat aux Assurances at 7, boulevard Joseph II, L-1840 Luxembourg, https://www.caa.lu/fr/accueil.
• Association des Compagnies d’Assurances (Service Médiation) at 12, rue Erasme, L -1468 Luxembourg, https://www.aca.lu/fr/mediateur-assurance,

All the above is without prejudice to any court action. For more information on complaints relating to Portuguese clients, refer to https://eu.lombardinternational.com/en-GB/Contact-us/Portuguese-Client-Information