Insurance in the Democratic Republic of the Congo

Insurance law in the Democratic Republic of the Congo is based for the private market primarily on Law No. 15/005 of 17 March 2015. The former monopoly of Sonas has ended. ARCA is the nationally competent state regulatory and supervisory authority under the Ministry of Finance. It grants licenses, monitors the financial stability of providers and protects policyholders. CNSS, governed by Law No. 16/009 of 15 July 2016, operates the general social security system instead. The formal market comprises life and non-life insurance. Life insurers include RAWSUR LIFE SA, AFRISSUR SA and ACTIVA VIE RDC SA. Non-life insurers include ACTIVA ASSURANCES RDC SA, SFA CONGO SA, RAWSUR SA, SUNU ASSURANCES IARD RDC SA, MAYFAIR INSURANCE CONGO SA, GLOBAL PIONNER ASSURANCE SA and SONAS SA. The provider's status and the specific product should be checked directly with ARCA before concluding a contract. In 2024, premiums amounted to USD 377.89 million, of which USD 342.80 million was for non-life insurance and USD 35.10 million for life insurance. Insurance penetration was 0.53 percent, insurance density was USD 3.46 per inhabitant and claims expenditure was USD 56.18 million. The formal market is therefore present nationwide, but outside major centers it may not reach all users equally well. CNSS covers, among other things, old-age pensions, disability, survivors, family benefits, maternity, and occupational accidents or diseases. The general system applies to employees, equivalent groups and other categories covered by law; voluntary insurance is also provided for. An old-age pension generally requires age 60, at least 180 months of insurance and the end of dependent employment. Voluntary early retirement may be possible from age 55; the mandatory age limit is 65. Disability benefits require at least 36 months of insurance within the last 20 quarters. Employers must register, report employees and pay contributions. Missing or insufficient payments can result in arrears, penalties and problems with benefits. Private insurance covers, for example, life, death, disability, property damage, liability, technical risks, fire, transport and business risks. Private health insurance is offered by health insurance administrators authorized by ARCA. For 2024, ARCA named GGA, MSO, Pactilis and Société Conseils Assistances en Santé. This does not establish a general private or state health insurance scheme for all residents; scope, access and benefits depend on the respective contract. Informal savings or solidarity groups may share risks, but they are not equivalent to regulated insurance. Legally required insurance includes, among other things, third-party liability insurance for owners of land motor vehicles, fire insurance for certain buildings and uses, construction insurance for damage to the structure and ten-year liability, air transport liability insurance, liability insurance for maritime, river and inland waterway transport, and insurance for imported goods. Motor vehicle coverage applies nationwide; an insurance certificate is required. The certificate must be issued no later than ten days after conclusion of the contract, and a provisional certificate may be valid for no more than one month. ARCA minimum rates apply to these products, but there are no uniform retail prices for all insurance. The premium, coverage limit, exclusions, payment method, currency and availability depend on the provider and the policy. Before concluding a contract, the written policy or notice should state the insured property or person, the risk, the coverage limit, the start date, the term, the premium, payment deadlines, renewal, cancellation, exclusions, duties and the procedure for reporting claims. Risk questions must be answered truthfully. Deliberately false statements may render the contract void or result in loss of benefits. A contract is amended through a signed amendment (avenant), usually called an avenant in French. An insured person should report a claim without delay in accordance with the policy and keep the policy, payment receipts and certificates safe. The statutory minimum period for general claims is eight working days; five days apply in cases of theft or livestock mortality, and 15 days in cases of fire involving bodily injury. Depending on the case, medical records, reports to the authorities, photographs, proof of ownership or an expert report may be required. The insurer must state the deadlines provided in the policy for assessment and compensation. A complaint begins with the intermediary or insurer. If the response is inadequate, the insured person should request a written final position and then contact ARCA. ARCA can investigate and mediate; the consumer service is free and should be processed within 60 days. An ARCA recommendation is not enforceable. The procedure does not apply, among other things, to cases already pending before a court or in another procedure, foreign policies, corporate complaints, professional disputes between insurers, or disputes concerning occupational accidents and diseases; CNSS is responsible for the latter. For contracts with a term of more than one year, the insured person may cancel on the anniversary date with at least one month's notice. In the event of a change of residence, occupation, retirement or family status, cancellation is possible within three months; it takes effect one month after notification, and premiums paid in excess are refunded proportionally. When a motor vehicle is sold, the contract is suspended from the fifth day. Cancellation is possible with ten days' notice; without reactivation or cancellation, the contract automatically ends after six months. If a premium is not paid, the insurer may suspend or cancel coverage only eight days after delivery of a demand for payment.