How do I file a complaint with the Insurance Commission?
Last updated: 2026-07-11 · Educational content; not legal advice.
Short answer
The Insurance Commission (IC) regulates insurance companies, HMOs, and insurance agents, and it accepts complaints against them. For a monetary dispute, RA 10607 (the Amended Insurance Code) Section 439 gives the Insurance Commissioner authority to adjudicate a claim under any insurance policy where the single claim does not exceed ₱5,000,000 (excluding interest, costs, and attorney's fees); larger claims go to the regular courts. You can also use the IC's public-assistance and mediation route for help resolving a dispute short of formal adjudication. Prepare a written complaint identifying the insurer/HMO, the policy, the facts, the amount, and the relief you seek, and attach your evidence.
Practical steps: (1) exhaust the insurer/HMO first and get its denial or last position in writing; (2) gather your policy or membership agreement, proof of loss/claim, correspondence, and a dated timeline; (3) write a verified complaint stating the parties, the facts, the specific RA 10607 provisions breached (e.g., Section 247 unfair claim settlement, Section 249/250 late payment and interest), the amount claimed, and the relief; (4) file with the Insurance Commission and keep proof of filing. Check the IC's official website for the current filing channels, office addresses, and any required forms before you submit, because intake details can change.
Primary sources
Frequently asked
How large a claim will the IC decide?
Under RA 10607 Section 439, the Insurance Commissioner can adjudicate a claim for loss, damage, or liability under an insurance policy where the single claim does not exceed ₱5,000,000, excluding interest, costs, and attorney's fees. Above that, the dispute belongs in the regular courts — though the IC's mediation and public-assistance function can still help you.
Do I have to go to court, or can the IC handle it?
For claims within the ₱5,000,000 ceiling you can seek adjudication at the Insurance Commission itself, which is faster and cheaper than court. The IC also offers a public-assistance / mediation route to try to settle a dispute without a full adjudication. Court is the venue for larger claims or where you prefer to litigate.
What should my complaint contain?
Identify yourself and the insurer or HMO, the policy or membership number, a clear statement of facts with dates, the specific violations (cite the RA 10607 sections, such as Section 247 for unfair claim settlement or Sections 249–250 for late payment and interest), the amount you claim, and the relief you want. Attach the policy, proof of loss, the written denial, and your correspondence.
Take action
Got a similar problem?
File a complaint and we'll pre-fill BSP, SEC, DTI, and small-claims letters for you.
Your rights as a policyholder or HMO member — what to do when an insurance claim is denied or delayed, how long an insurer has to pay a valid claim and the interest it owes for unreasonable delay (RA 10607, the Amended Insurance Code), the 2-year incontestability clause on life policies, HMO coverage and pre-existing-condition denials (now regulated by the Insurance Commission under EO 192 s.2015), what CTPL motor insurance covers and the no-fault indemnity, premium grace periods and lapsed policies, cash surrender value when you cancel, and how to file a complaint with the Insurance Commission.