Client vs Insurance Company in North Macedonia – How to Claim Compensation

When an insurance company refuses to pay a claim — or pays less than expected — many policyholders assume that the only option is to go to court. In practice, there are several effective out-of-court routes available in North Macedonia that can resolve the dispute faster and at lower cost. This guide explains the options available to policyholders who believe their insurance company has not properly handled their claim. This page is part of our practice in litigation.

The business model of insurance companies is more successful and profitable if the insurance company sells more insurance policies on the one hand, but also if it manages to reduce costs. In addition to the standard costs for each company, insurance companies are faced with the challenge of paying out sums for the payment of claims to those insured who have suffered a certain loss.

Thus, if we accept that each insurance company should present itself to its shareholders as a profit center, we must also accept that the motive of each insurance company is to find a way to reduce the amount of damage that it has to pay out to its policyholders, or else to reject the claim completely.

Bearing this in mind, the following sections discuss the ways of obtaining compensation from an insurance company without starting court proceedings.

I. Complaint to the Insurance Supervision Agency (ASO)

At the moment when the insured submits a request to be compensated, the interests of the insurance company and the insured are opposite — the insurance companies are motivated to refuse the claim or pay a smaller amount.

For this reason, the insured can find a way to negotiate with the insurance company or start legal proceedings against it. However, they also have the opportunity to submit a complaint to the Agency for Supervision of Insurance (ASO) in order to obtain compensation from the insurance company. The ASO is obligated to protect the rights of policyholders and other insurance users in accordance with the Law on Consumer Protection, the Law on Supervision of Insurance and the Law on Obligations.

II. What to Expect from the Insurance Supervision Agency

The Agency for Supervision of Insurance has been taking this mechanism for exercising policyholder rights increasingly seriously from year to year. According to the Agency’s announcements, the total number of complaints filed by dissatisfied insured persons in 2022 reached 267, which represented a 30% increase compared to 2021.

The Agency emphasizes that this data is a clear indicator that citizens increasingly recognize the Insurance Supervision Agency as a protector of their insurance rights. In 2022, the ASO resolved 62 complaints in favor of policyholders who complained about the quality of services they received from insurance companies — 48% more than in 2021.

III. How to Submit a Complaint to the Insurance Supervision Agency

There are several ways to submit a complaint to the Agency. It can be submitted personally by the insured or through an authorized proxy. The complaint can be submitted electronically or to the Agency’s archive.

It is recommended that the complaint be well-reasoned and that all relevant evidence — including the decision made by the insurance company — be submitted together with it.

IV. Other Out-of-Court Routes

Under the Law on Supervision of Insurance, the insured — or the beneficiary of the insurance — who believes that the insurance company is not complying with the provisions of the insurance contract may also submit a complaint to:

1) The appropriate organizational unit responsible for resolving disputes between contracting parties within the insurance company;

2) The internal audit service of the insurance company;

3) A consumer protection organization; and

4) The Insurance Supervision Agency.

For further information about the ASO’s complaint procedure, visit the Insurance Supervision Agency website.

Practical Checklist

If an insurance company has refused or reduced your claim in North Macedonia, take the following steps: (1) Request a written explanation — ask the insurance company to provide its decision in writing with the specific grounds for refusing or reducing the claim. This is the basis for any further action. (2) Gather all documentation — collect the insurance policy, all correspondence with the insurance company, the damage assessment, photos and any other evidence supporting the claim. (3) Submit an internal complaint first — most insurance companies have an internal complaints unit. Submitting an internal complaint is both a legal right and a practical step — it creates a written record and may resolve the issue without further escalation. (4) File a complaint with the ASO — if the internal complaint does not produce a satisfactory result, file a complaint with the Insurance Supervision Agency. The complaint can be submitted electronically at aso.mk or in person. The procedure is free. Include all documentation and clearly state the specific breach or decision you are challenging. (5) Keep records of all submissions — retain confirmation of every submission (email receipts, registered post confirmations, archive stamps) in case the matter proceeds further. (6) Consider legal assistance — if the claim is significant or the insurance company’s position is entrenched, engaging a lawyer before escalating can significantly improve the outcome. 

Frequently Asked Questions

Is the ASO complaint procedure free?

Yes. Filing a complaint with the Insurance Supervision Agency (ASO) is free of charge for the insured. The procedure can be initiated electronically or in person, either by the insured directly or through an authorized proxy.

Does complaining to the ASO stop the insurance company from proceeding with its position?

Not automatically. The ASO complaint procedure runs separately from any negotiations or potential court proceedings. However, the ASO has powers to investigate and to require the insurance company to comply with its obligations. A decision by the ASO in favor of the insured creates significant pressure on the insurance company to pay.

What should a complaint to the ASO contain?

The complaint should be well-reasoned and clearly identify: the insurance policy in question; the specific decision or conduct of the insurance company being challenged; the legal or contractual basis for the challenge; and all supporting evidence (policy documents, correspondence, damage assessments, photos). A well-documented complaint significantly improves the chance of a favorable outcome.

Can I file a court case at the same time as complaining to the ASO?

Yes. The ASO complaint procedure and court proceedings are not mutually exclusive. However, pursuing the ASO route first is often more efficient — it is faster, free, and may resolve the dispute without the cost and time of litigation. If the ASO procedure does not succeed, court proceedings remain available.

What if the insurance company simply ignores the outcome?

If the insurance company does not comply with the ASO’s decision or recommendations, the insured can escalate to court proceedings. The ASO’s file and findings can be useful evidence in subsequent litigation. In cases of persistent non-compliance, the ASO also has supervisory and enforcement powers over licensed insurance companies.

Last updated: August 2026

Note: The above does not constitute legal advice and in no way can be accepted or understood as an instruction to act in a specific case. Each legal situation has its own characteristics that should be reviewed at separately, and for that reason we recommend that you contact a professional – a lawyer – for legal advice.