Public warning to Pohjola Insurance Ltd for non-compliance with time limits under Workers’ Compensation Act and provisions concerning system of governanceThe Financial Supervisory Authority (FIN-FSA) has issued a public warning to Pohjola Insurance Ltd. The company has failed to commence the processing of claims, issue decisions and submit statutorily required documents to the appropriate appeal body within the time limits provided in the Workers’ Compensation Act. Furthermore, the company has lacked adequate internal control for claims function and reporting as well as information systems concerning claims function producing adequately reliable information.
The purpose of the time limits provided in the Workers’ Compensation Act is to accelerate the processing of claims and issuing decisions, and to improve appellants’ legal protection. The purpose of the system of governance is to ensure that the company is managed in line with sound and prudent business principles and that these principles are followed in the company’s activities.
Pohjola Insurance Ltd has failed to comply with the provisions of the Workers’ Compensation Act on time limits extensively and for a long time. In the period from April 2020 to May 2021 and from January to November 2022, the company has failed to commence the processing of several claims without delay and no later than seven working days after the institution of the claim. Furthermore, in 2019–2022, the company has failed to issue several statutorily required decisions promptly and no later than 30 days from having received adequate reports to resolve the matter. In addition, regarding several appeal matters in the period from January 2019 to March 2021, the company has failed to submit statutorily required documents to the appeal body within 30 days of the end of the appeal period or, concerning matters requiring further evidence, no later than 60 days after the end of the appeal period. Finally, the company has failed to comply with the provisions of the Insurance Companies Act and Commission Regulation (EU) No 2015/35 in 2019–2022, in lacking adequate internal control covering claims function and reporting pertaining to the Workers’ Compensation Act as well as information systems producing adequately reliable information regarding compliance with the two time limits.
Imposition of a penalty payment instead of issuing a public warning is not provided in the applicable provisions. A public warning has been issued to Pohjola Insurance Ltd for these omissions. The decision is not yet legally binding. The company has the right to appeal the decision to the Helsinki Administrative Court within 30 days of receipt of notice of the decision. Information on the legal validity of the decision is available on the FIN-FSA website.
For further information, please contact
Janne Häyrynen, Head of Unit.
Requests for interviews are coordinated by FIN-FSA Communications, tel. +358 9 183 5030 (weekdays 9:00–16:00).
- Decision of the Financial Supervisory Authority (pdf, in Finnish)