Scope and Application
- Applies to all financial products and services regulated by the Insurance Commission covering insurance, pre-need, and HMO sectors.
- Includes digital financial products and services.
Key Definitions
- Defines critical terms such as cooling-off period, financial consumer, complaint, financial products/services, financial service providers, ICREs, marketing, responsible pricing, and market conduct.
- Cooling-off period allows consumers to cancel contracts within a specified time with full refund unless claims are made.
Fair and Equitable Treatment of Consumers
- Financial consumers shall be treated fairly, honestly, and professionally through all transaction stages.
- ICREs must conduct suitability and affordability assessments.
- Must ensure fairness of terms and evaluate products for consumer relevance and affordability.
- Required to adopt and align a Code of Conduct with market conduct guidelines focusing on consumer protection.
Disclosure and Transparency
- Consumers have a right to clear, concise, and full disclosure before, during, and post-sale.
- Important terms such as risks, rights, costs, and consequences must be fully disclosed.
- Complex products require a key facts statement (Product Highlight Sheet).
- Changes in product terms must be notified 30 days before implementation.
- Advertising must not be misleading or deceptive.
- Mandates cooling-off periods depending on contract duration.
- Consumers must receive copies of signed documents and proofs of transactions.
Protection against Fraud and Misuse
- ICREs are responsible for safeguarding consumer assets from fraud and misuse.
- Clear mechanisms for complaint handling involving fraud and unauthorized transactions are mandated.
Privacy and Data Protection
- Consumers’ personal and financial data must be kept confidential and secured.
- ICREs must implement data security standards consistent with the Data Privacy Act of 2012 and National Privacy Commission regulations.
Timely Handling and Redress of Complaints
- ICREs must provide accessible, independent, fair, and efficient complaint resolution mechanisms.
- Requirements include complaint acknowledgment within two working days and resolution within designated periods depending on issue complexity.
- Must maintain logs, provide information access, perform complaint pattern analysis, and allocate sufficient resources.
Consumer Protection Risk Management System (CPRMS)
- ICREs must establish a CPRMS integrated into enterprise risk management frameworks.
- CPRMS covers governance structure, policies, processes, measurements, and control procedures.
- Board of Directors approves and oversees CPRMS, reviews Code of Conduct, ensures resources and remedial actions.
- Senior management responsible for policy implementation, monitoring consumer risks, and reporting.
Consumer Assistance Management System (CAMS)
- ICREs required to establish CAMS for efficient receipt, recording, evaluation, and resolution of consumer complaints.
- CAMS must have dedicated teams separate from claims handling units.
- Manuals detailing procedures, timelines, capacity building, and record keeping must be established.
- Consumer assistance channels must include multiple accessible options (e.g., walk-ins, online portals, hotlines).
- Consumer complaint data must be thoroughly recorded and analyzed.
- Quarterly reports submitted to Boards and the Commission.
Market Monitoring
- Commission conducts ongoing market monitoring to identify issues such as mis-selling, license violations, and pricing irregularities.
- Uses data from public and private sectors and various media to assess market conduct and consumer risks.
Market Conduct Surveillance and Examination
- Commission authorized to perform on-site and off-site surveillance and examinations separate from prudential reviews.
- Can interview personnel, review documents, and compel evidence to ensure compliance.
Handling of Informal Complaints
- Provides informal complaint resolution framework optional for consumers.
- Process initiated via submission of Claimant's Assistance Request Form with supporting documents.
- Commission evaluates submissions and may conduct mediation/conciliation within set timelines.
- Failure to resolve may lead to formal adjudication or administrative action.
Adjudication Process
- Commission adjudicates claims below prescribed monetary thresholds.
- Verified complaints require specific details and docket fees based on claim amounts.
- Respondents have fifteen working days to file verified answers.
- Failure to answer may result in judgment based on evidence submitted.
Enforcement and Sanctions
- Commission empowered to impose enforcement actions including fines, suspensions, restrictions, cease-and-desist orders without prior hearing in urgent cases.
- Administrative sanctions apply to violators including directors and employees.
- ICREs liable for acts and omissions of representatives and third-party service providers.
Additional Provisions
- Digitization of Commission's processes for complaint filing and resolution.
- Organizational and personnel enhancements within the Commission for effective law implementation.
- Transparency in releasing consumer protection data subject to privacy laws.
- Prohibits clauses that waive consumers' rights to sue or data protection.
Final Provisions
- Prescription period of five to ten years for actions arising under the law depending on circumstances.
- Transitional period granted for ICREs to analyze and comply with rules.
- Repeals inconsistent prior issuances.
- Rules take effect 15 days after publication.