Law Summary
Definitions of Key Terms
- Mediation: Facilitated negotiation to achieve voluntary, mutually satisfactory resolution.
- Conciliation: More active role by conciliator to assist disputants in formulating amicable solutions.
- Mediator/Conciliator: Qualified individual delivering conciliation-mediation services.
Salient Features of Mediation and Conciliation
Mediation
- Structured process with defined stages.
- Parties decide the outcome based on needs and interests rather than positions.
- Mediator acts as impartial facilitator, no advice or judgment.
- Outcome: Mutual acceptance or win-win resolution.
Conciliation
- Less structured, follows negotiation dynamics.
- Parties decide the outcome guided by conciliator suggestions.
- Conciliator may provide opinions and advice but cannot impose judgments.
- Outcome: Best compromise acceptable to all parties.
Structural Elements of ADReM
- Least cost: Affordable to all stakeholders.
- Accessible: Convenient and easy to understand.
- Practical: Feasible and appropriate to microinsurance sector needs.
- Maximizes existing resources for sustainability.
- Effective: Results in doable, mutually acceptable agreements.
- Timely: Swift resolutions within regulator-prescribed timelines.
ADReM Procedures for Individual Cooperative Members
- Complaints filed with primary cooperative's mediation-conciliation committee, specifying insured's name, policy details, insurance company, claim nature and amount.
- Complaint recipient must notify insurance provider within 24 hours and initiate a preliminary conference within 3 working days.
- Parties agree on mediator-conciliator from an official roster, venue, and schedule.
- If no agreement on mediator or schedule, complainant may elevate complaint to Cooperative Insurance Society (CIS) or the Insurance Commission (IC).
- Proceedings held at mutually agreed venues; legal counsels are not allowed.
- Proceedings to complete within 30 working days; settlement agreements must be signed with authorized representation.
- Absence of settlement or parties missing two consecutive sessions allows escalation to higher levels.
ADReM Procedures for Primary Cooperatives
- Complaints filed with CIS mediation-conciliation committee with requisite details.
- Complaint recipient must notify concerned insurer within 24 hours and hold a preliminary conference within 3 working days.
- Agreement needed on mediator-conciliator choice, venue, and schedule.
- Failure to agree enables elevation to the Insurance Commission.
- Proceedings held in agreed venues; legal counsels not allowed.
- Completion expected within 30 working days; settlement agreements require authorized signatures.
- Non-resolution or absenteeism permits direct escalation to the Insurance Commission.
Fee Structure
- Mediator-conciliators may charge fees not exceeding Php 500 or such amount as determined by the Insurance Commission.
- Cost-sharing can be agreed upon by parties.
Information Campaign
- Cooperative Insurance Societies (CIS), distribution partners, agents, and brokers are tasked to promote mediation and conciliation as dispute resolution options for policyholders.
Reporting Requirements
- CIS must report outcomes of cases undergoing ADReM processes in Annual Statements.
Governing Rules Compliance
- ADReM processes adhere to rules on confidentiality, competence, impartiality, consent, self-determination, and enforcement of settlements as mandated by RA 9285 and its IRR.
Effectivity
- Guidelines take effect immediately upon issuance.