Fiva issued a public warning to Pohjola Insurance regarding the prolonged processing times for statutory occupational accident and occupational disease insurance claims.
Banks and the Financial Supervisory Authority (Fiva), which supervises insurance companies, has issued a public warning to Pohjola Insurance.
According to Fiva, the company has not started the investigation of compensation issues quickly enough, issued decisions and did not deliver the prescribed documents to the relevant appeals body within the deadlines stipulated in the Work Accidents and Occupational Diseases Act.
The company has also not had sufficient internal control covering compensation activities and reporting, nor information systems that have produced sufficiently reliable information in compensation activities.
Fiva says in its press release that Pohjola Insurance has not started the investigation of several compensation cases between April 2020 and May 2021 and between January and November 2022 without delay and within seven business days at the latest.
In the years 2019−2022, the company has also not issued several stipulated compensation decisions without delay and at the latest within 30 days after it has received sufficient explanations to resolve the matter.
In addition, from January 2019 to March 2021, in several appeal cases, the company has not submitted the prescribed documents to the appeals body within 30 days of the end of the appeal period or, in cases requiring additional clarification, no later than 60 days after the end of the appeal period.
According to Fiva, the company has also neglected to comply with the provisions of the Insurance Companies Act and the EU Commission’s regulation in the years 2019−2022 due to deficiencies in internal control and information systems.
According to Fiva, the company did not have sufficient internal control covering the compensation activities and reporting related to the Occupational Accidents and Occupational Diseases Act, nor information systems that produced sufficiently reliable information regarding compliance with the two deadlines.
Pohjola Insurance does not incur penalty payments for those who fail to do so. If the company wishes, it has the right to appeal Fiva’s decision to issue a public warning to the administrative court.
North The insurance company says in its press release that it does not intend to appeal Fiva’s decision.
According to the company, the deficiencies detected by Fiva in meeting the statutory deadlines have been “almost completely corrected”.
At the moment, Pohjola Insurance takes over the statutory work accident and occupational disease insurance claims within the deadline, the company’s press release says. As far as compensation decisions are concerned, the company is almost completely on time.
“We apologize for the inconvenience to our customers. We take compliance with statutory deadlines and the warning of the Financial Supervisory Authority very seriously. We have significantly increased the number of personnel handling these claims, carried out large-scale system development and increased the skills of claims processing professionals in order to remedy the situation,” says the CEO of Pohjola Insurance Vesa Aho in the bulletin.
Pohjola Insurance says in its press release that it has also corrected the deficiencies in the organization of internal control from 2020.
Financial Supervisory Authority most recently criticized the OP group’s money laundering-related activities in harsh terms in August. Pohjola Insurance is part of the OP group.
Head of Fiva’s office responsible for anti-money laundering supervision Pekka Vasara said at that time to HS that the fight against money laundering in co-operative banks gets a school grade of “necessary”.
Fiva investigated the adequacy of the bank’s prevention systems in 2021–2022. This is the first anti-money laundering audit conducted on the OP group. The completed inspection report is dated December 2022.
Fiva’s report revealed major flaws, especially in the cooperative bank of South Karelia. The bank quickly started terminating its customers after Fiva had started an anti-money laundering audit at the bank.
In addition, Fiva also found 146 personal customers in the Turku region’s cooperative bank, whose possible political influence the bank had not investigated.
OP company bank, on the other hand, was criticized for not having obtained passport copies of the foreign company’s actual beneficiaries, because “it has been difficult to obtain them”.
The OP group told HS in August that it has “carefully analyzed” Fiva’s findings and ensured that the necessary corrections are made. In addition, CEO of the OP Group Timo Ritakallio told HS via text message that OP has given the Financial Supervisory Authority a response regarding the inspection.
#Insurance #companies #Public #warning #Fiva #Pohjola #Vakuutus
