The insurance ombudsman in Kazakhstan helps resolve disagreements between a client and an insurance company without a complex court process. People turn to the ombudsman over a refused payout, disagreement with the amount of compensation, a dispute over the assessment of damage, contract termination and other issues in performing an insurance contract.

Since 1 January 2024, applying to the insurance ombudsman has been a mandatory stage of pre-trial settlement of insurance disputes. It is therefore important, before filing a lawsuit, to record the claim correctly, gather the documents and follow the prescribed procedure. Consideration of an application is free of charge for the applicant.

Who the insurance ombudsman is

The insurance ombudsman is an independent mediator who considers disputes arising from insurance contracts. The ombudsman's task is to study the parties' positions, the documents and the circumstances of the insured event objectively, and to help reconcile the parties or make a decision within their competence.

The ombudsman is not an employee of any particular insurance company and does not replace the court. However, the ombudsman's decision is binding on the insurer, and an applicant who disagrees with the outcome retains the right to go to court. This procedure makes it possible in many cases to resolve a dispute faster and without court costs.

When you can apply

Refused payout

The insurer has stated that the event is not recognised as an insured event, has cited an exclusion or has not provided a clear justification.

Amount of compensation

The client disagrees with the payout calculation, depreciation, the list of damage, the repair estimate or the assessment of harm to life and health.

Performance of the contract

A dispute has arisen over deadlines, the parties' obligations, suspension of cover, early termination of the contract or the refund of part of the premium.

Individuals and small business entities may apply in disputes under all types of insurance if the claim does not exceed 10,000 MCI. For other legal entities, competence is limited to disputes under compulsory motor third-party liability insurance. Before filing, check the current conditions on the ombudsman's official website.

How to file an application: step by step

  1. Write to the insurance company. State your claim, attach supporting documents and inform the insurer of your intention to apply to the ombudsman. Keep a copy of the application and proof that it was received.
  2. Wait for a reply. If the matter is not resolved within three working days, or no reply is received, you may send your application to the ombudsman.
  3. Put together a single set of documents. It is better to arrange the materials by date in advance and briefly describe which decision of the insurer is being disputed.
  4. Submit the application. You can do this through the official website fomb.kz, by email at info@fomb.kz, or in person at the address shown on the official resource.
Important: do not rely on a verbal conversation with a manager. To confirm the pre-trial procedure, you need written applications, replies, notices and proof of dispatch.

Which documents to prepare

  • an application with a brief, consistent description of the situation and a specific demand;
  • the applicant's identity document, or the representative's documents and power of attorney;
  • the insurance policy or insurance contract, the rules and annexes to it;
  • the insured event claim and documents confirming the circumstances of the event;
  • the insurance company's decision, refusal letter or payout calculation;
  • a valuation report, defect inspection report, service station estimate, photographs and other evidence of the amount of damage;
  • medical documents and proof of expenses, if the dispute concerns harm to life or health;
  • correspondence with the insurer and proof of the prior application.

The set of documents depends on the type of insurance and the subject of the dispute. If a refusal is being disputed, it is particularly important to attach the insurance company's official reply. Illegible photographs, incomplete pages of the contract and missing dates make the review more difficult.

How an insurance dispute is considered

The ombudsman studies the documents of both parties, may request additional information, hear explanations and propose a conciliation solution. In a dispute over the amount of damage, an additional assessment may be needed. According to the regulator, such an assessment within the procedure may be carried out free of charge for the applicant.

The outcome may be a settlement of the disagreement, a decision, a recommendation or an explanation on the substance of the issue. If the client does not accept the outcome, they have the right to protect their interests in court. The claim should be accompanied by documents confirming that the mandatory pre-trial stage was completed.

Disputes after a road accident

Under compulsory motor insurance, disagreements are often related not to the accident itself but to the list of damage and the cost of repairs. Check whether all damaged parts were included in the inspection report, whether the estimate matches the nature of the impact and whether the service station's documents were taken into account. Before repairs, keep detailed photographs of the vehicle and do not throw away replaced parts if they may have evidentiary value.

Where harm is caused to life or health, medical and other official documents form the basis of the calculation. Keep reports, prescriptions, receipts, information on incapacity for work and documents confirming the link between the expenses and the incident.

Voluntary insurance and early termination

In CASCO, property, travel, life and other voluntary insurance contracts, the definitions of an insured event, exclusions, territory and period of cover, notification obligations, the list of documents and the payout calculation procedure are especially important. Before a dispute, compare the insurer's decision not only with the advertising description of the product but also with the signed contract and the insurance rules.

When a contract is terminated early, the amount of the premium refund depends on the grounds for termination, the terms of the contract and the legislation in force. There is no universal calculation for all situations. Ask the insurer for a written calculation stating the legal and contractual basis for each deduction.

Archived video lecture

Below is a video lecture on the ombudsman's working principles, damage assessment and typical insurance disputes. The video is useful for understanding the topic, but it was published earlier, so information about the procedure and contact details must be checked against current official sources.

Topics of the video lecture

  • the independence, objectivity and impartiality of the insurance ombudsman;
  • how a conciliation procedure differs from a court of general jurisdiction;
  • consideration of disputes under compulsory motor insurance;
  • assessment of vehicle damage and of harm to life or health;
  • the complexities of voluntary insurance contracts and early termination.
In brief: first send a written demand to the insurer, then gather a full set of evidence and file a free application through the ombudsman's official resource. Set out not only your claim but also the specific result you expect: review of the refusal, recalculation of the payout, an assessment or a refund of part of the premium.

This material is for information purposes only. The procedure, competence and contact details may change; before filing an application, check the current requirements on fomb.kz and on the resources of the Agency of the Republic of Kazakhstan for Regulation and Development of the Financial Market (ARDFM).