Decision on Applying a Coercive Fine to IM CIA TRANSELIT SA for Non-Execution of CNPF Decision No. 36/2

REPUBLIC OF MOLDOVA
NATIONAL FINANCIAL MARKET COMMISSION
77 Stefan cel Mare si Sfant Blvd., Chisinau, MD 2012, tel: (373 22) 859 401, www.cnpf.md, e-mail: office@cnpf.md

DECISION
28 April 2026 No. 20/3

On the application of a coercive fine to IM CIA "TRANSELIT" SA for non-execution of Decision No. 36/2 of the National Financial Market Commission dated 29.07.2025 regarding the results of the thematic control conducted within IM CIA "TRANSELIT" SA.

On 29.07.2025, the National Financial Market Commission (CNPF) adopted Decision No. 36/2 regarding the results of the thematic control conducted within IM CIA "TRANSELIT" SA (hereinafter: Decision No. 36/2/2025/Decision).

In this case, according to points 2–5 of the operative part of Decision No. 36/2/2025, the CNPF found that IM CIA "TRANSELIT" SA (the insurer) had:

1. Used aggressive commercial practices as provided for in Art. 13 para. (1) and para. (17) of Law No. 105/2003 on consumer protection, by requesting the consumer wishing to execute an insurance policy to present documents that, reasonably, cannot be considered relevant to establish whether the claim is valid, or by systematically ignoring relevant correspondence, with the aim of inducing the consumer to waive their right to benefit from insurance compensation, as described in point 1 of the explanatory part of the Decision and in the Control Act;

2. Violated Art. 89 para. (1) lit. a) and lit. b) of Law No. 92/2022 on insurance or reinsurance activity (Law No. 92/2022), by including in the Insurance Contract and the Insurance Conditions clauses contrary to the provisions of Art. 1828 para. (1) and para. (3) and Art. 1851 para. (3) of the Civil Code;

3. Violated Art. 89 para. (1) lit. a) and lit. b) of Law No. 92/2022, by failing to properly fulfill obligations deriving from the Insurance Contract, in particular by:
   3.1. Unjustified refusal to pay insurance compensation (in whole or in part), without clear justification or without an objective analysis of evidence;
   3.2. Delaying the examination of compensation claims and lack of transparency in resolving damage files, including non-communication of decisions adopted by the insurer to entitled persons, contrary to point 7.3 of the Insurance Contract and point 8.13 of the Insurance Conditions;

4. Violated Art. 89 para. (1) lit. e) of Law No. 92/2022, by failing to respect the deadlines for paying insurance compensation, according to point 7.4 of the Insurance Contract and point 8.13 of the Insurance Conditions.

Based on points 6–8 of Decision No. 36/2/2025, IM CIA "TRANSELIT" SA was ordered:

1. To prohibit the use of incorrect commercial practices, as well as those similar to them, described in point 1 of the explanatory part of the Decision;
2. To revise the model of the Insurance Contract and the Special Conditions for medical insurance for travel abroad, in order to bring them into conformity with legal provisions (taking into account the findings in point 2 of the explanatory part of the Decision);
3. To review damage files settled during the period 01.01.2024 – 31.12.2024, in order to identify all cases where unjustified decisions of total or partial refusal to pay insurance compensation were issued to injured persons and to remedy these situations accordingly.

Consequently, Decision No. 36/2/2025 was communicated to the insurer via CNPF letter No. 04-5/3211, sent to the email address office@transelit.md on 01.08.2025.

Therefore, within 90 days from the date of communication of the Decision, the insurer was obliged to submit monthly information, by the 10th of each month, regarding measures taken, accompanied by supporting documents.

In this regard, via letter No. 1537/2025 dated 15.09.2025 (registered at CNPF with No. 6823 on 15.09.2025), IM CIA "TRANSELIT" SA informed that, by Order No. 36/1 dated 04.08.2025, it was ordered:
"1. Revision of the model of the application for processing damage files (revised and attached to the letter), the model of the Insurance Contract, and the Special Conditions for medical insurance for travel abroad;
2. Review of damage files settled during the period subject to control, regarding refusal and delay in paying insurance compensation;
3. Identification of injured persons and remediation of situations of total or partial refusal."

At the same time, the insurer mentioned that it was in the process of drafting the Regulation on procedures for processing damage files.

Subsequently, via letter No. 1712/2025 dated 15.10.2025 (registered at CNPF with No. 7489 on 15.10.2025), the insurer communicated that:
",- the general damage section is in the finalization stage of the Regulation on procedures for processing damage files;

• revision and modification of Insurance Contracts, as well as Special Conditions for medical insurance for travel abroad, will follow a separate procedure with the CNPF, in order to align them with new regulatory requirements, transparency standards, and protection of consumer rights. These adjustments aim to improve the clarity of contractual clauses, eliminate inconsistencies, and ensure more efficient communication between the company and the insured."

Via letter No. 1865/2025 dated 11.11.2025 (registered at CNPF with No. 8185 on 11.11.2025), IM CIA "TRANSELIT" SA informed about:
",- completion of the draft Regulation on procedures for processing damage files;

• conclusion of the analysis of the existing contractual framework, elaborating a set of consolidated recommendations regarding adjustment of clauses in mandatory and optional insurance contracts, including regarding transparency of compensation conditions and protection of personal data;
• conducting selective checks of damage files from the third quarter of 2025, for the purpose of assessing compliance with procedures and deadlines provided for in specialized legislation;
• revision and updating of internal forms used in the process of receiving and processing compensation claims, to simplify interaction with the insured and reduce risks of non-uniform interpretation."

Additionally, via letter No. 2007/2025 dated 10.12.2025 (registered at CNPF with No. 10016 on 11.12.2025), IM CIA "TRANSELIT" SA informed that it had revised 11 damage files, as follows: […]; […]; […]; […]; […]; […]; […]; […]; […]; […]; […].

At the same time, the insurer declared that, "As a result, the person designated for the revision of the aforementioned files cited the persons involved in the damage files, requesting their presentation at the company's headquarters to initiate the file re-examination procedure."

In this context, it should be noted that at that stage, the insurer had not presented/attached confirmatory documents related to the case.

Subsequently, on 16.01.2026, via letter No. 04-5/110, the CNPF communicated to the insurer about the initiation, ex officio, of the administrative procedure, aimed at verifying the actions taken by the insurer, in order to execute Decision No. 36/2/2025, and requested, for this purpose, the presentation of corresponding information by 10.02.2026.

Subsequently, via letter No. 0207/2026 dated 10.02.2026 (registered at CNPF with No. 861 on 11.02.2026), the insurer informed that, "[...] returning to the actions taken previously within the process of revising damage files settled during the period 01.01.2024-31.12.2024, namely 11 damage files, respectively: […]; […]; […]; […]; […]; […]; […]; […]; […]; […]; […], communicates. Within the verification procedures and institutional communication related to these files, notifications were sent to consumers, but no responses were received. [...]".

At the same time, regarding the information presented by the insurer via letter No. 0207/2026 dated 10.02.2026, it should be noted that the list of revised damage files was attached, from which in 28 damage files, according to the control act, payment of insurance compensation was unjustifiably refused (partially or totally).

At the same time, regarding damage files where the decision related to the insured case was not communicated to the injured person, out of 18 files mentioned in the control act, the insurer communicated that in 8 cases it had sent the corresponding decision to the injured persons, attaching receipt notices, without presenting the information letters sent to the persons concerned.

Following the above, via Decision No. 8/6 dated 17.02.2026 regarding the summons to execute by IM CIA "TRANSELIT" SA of Decision No. 36/2 of the National Financial Market Commission dated 29.07.2025 regarding the results of the thematic control conducted within IM CIA "TRANSELIT" SA (Decision No. 8/6/2026), the CNPF found non-fulfillment by IM CIA "TRANSELIT" SA of points 6–8 of Decision No. 36/2/2025, especially:

• non-presentation of the revised model of the Insurance Contract and Special Conditions for medical insurance for travel abroad (according to what was communicated via letter No. 1712/2025 dated 15.10.2025), specifying the modifications made;
• no definitive versions of probative documents regarding the elaboration and approval of the Regulation on procedures for processing damage files were attached (according to what was communicated via letter No. 1865/2025 dated 11.11.2025), including the corresponding damage files that constituted the object of the thematic control for the period 01.01.2024 – 31.12.2024 were not subject to corresponding revision.

At the same time, via Decision No. 8/6/2026, the CNPF summoned the insurer to execute, within 60 days from the date of communication of the Decision, the obligations provided for in points 6–8 of Decision No. 36/2/2025, being warned that, in case of non-execution of the obligations, a coercive fine in the amount of 400 conventional units, equivalent to 20,000 MDL, would be applied.

Regarding the administrative procedure, by Order of the CNPF President No. 55 dated 11.02.2026 regarding the extension of the general term of the administrative procedure, initiated ex officio by CNPF letter No. 04-5/110 dated 16.01.2026, the term of the administrative procedure was extended by 15 days.

At the same time, by Order of the CNPF President No. 72 dated 20.02.2026 regarding the suspension of the administrative procedure, initiated ex officio by CNPF letter No. 04-5/110 dated 16.01.2026, the administrative procedure was suspended from 21.02.2026 until 21.04.2026 (inclusive).

Subsequently, on 17.04.2026, within the CNPF, letter No. 0706/2026 of IM CIA "TRANSELIT" SA was registered with No. 2851, in which the following is mentioned:

1. "[...] IM CIA "TRANSELIT" SA has modified the Special Conditions for medical insurance for travel abroad, Class 2 Health Insurance, in accordance with CNPF requirements and civil legislation. We communicate that on 17 April 2026, the Insurance Conditions were approved and submitted to the CNPF, approved by Order No. 12, through which the prescribed modifications for Class 2 Health Insurance, Special Conditions for medical insurance for travel abroad, were made." Confirmations of payment during the period 17-23.03.2026, related to 12 damage files, were attached:
   [...], [...], [...], [...], [...], [...], [...], [...], [...], [...], [...], [...], [...]".

Likewise, it is specified that the 12 settled and paid damage files total a value of […] MDL. Regarding damage files No. […] and No. […], the insurer invoked technical impediments in paying insurance compensation, as well as the impossibility of presenting persons on the territory of the Republic of Moldova, as they are non-residents.

2. "Refused Files: The CNPF identified 24 damage files, of which 4 files – […], […], […] and […] – represent cases where IM CIA "TRANSELIT" SA mentions the following: The refusal in the indicated damage files was dictated by the fact that the declared events do not fall under the provisions of the insurance contracts, as those risks were not insured. [...] Thus, the declared event does not fall under the incidence of the optional travel abroad insurance contract for the following reasons according to Art. 1829 para. (3) of the Civil Code. [...] Thus, it results that the Insurer pays only if: an event expressly provided for in the contract (insured risk) occurred, and generated expenses covered by the Insurance Policy. The events declared in the damage files are generic, qualified as "medical control at the Airport," which were carried out without any illness or accident being detected as a result. [...] In this case, from the formulation of the Contract's object, it appears that the following are covered: "unforeseen expenses for medical treatment, borne by the insured, due to sudden illness and/or an accident occurring during the temporary stay abroad, as a result of the insured event."

In this context, the following findings of the control team in the Control Act are recorded: the passing of the "Fit to Fly" procedure (medical certificate of fitness to fly), in itself, is not automatically considered as the occurrence of the insured risk under the medical insurance policy for travel abroad, but constitutes an insured risk if it has a direct effect on the occurrence of an insured risk, a situation characteristic of the damage file. By its actions, the insurer ignored the provisions of point 2.3 of the Insurance Contract and point 4.1.3 of the Insurance Conditions, according to which the Insurer covers the following expenses: outpatient treatment, including expenses for [...] diagnostic investigations [...], which does not release the insurer from liability.

3. "Files not subject to revision: […], […], […] and […]. IM CIA "TRANSELIT" SA has revised the mentioned files, but the previous position remains unchanged. (i) Regarding damage file No. […], in which the insured is Mr. […], [...] invoices issued by "[…]" material claims were addressed directly to citizen […] and no material claims were submitted to IM CIA "TRANSELIT" SA. Under these conditions, payment of insurance compensation cannot be made in favor of Mr. […], as no expenses were borne by him for the amounts requested. Currently, IM CIA "TRANSELIT" SA is examining the only possibility of regularizing the damage file by attributing the insurance compensation to the beneficiary, namely the medical institution in […] that provided the services and which is to submit the corresponding notifications, which has not been done so far."

The insurer is obliged to process the damage file in good faith and with diligence, including by clarifying all relevant circumstances, and cannot justify an exclusive refusal solely due to the lack of formal requirements not expressly provided for in the contract.

4. "[...] Regarding damage file No. […], in which the insured declared the event occurring on 01.05.2024 only on 24.05.2024, this constitutes a violation, generated by the deprivation of the Insurer's possibility to verify the circumstances of the case in a timely manner for 23 days [...]. [...] The decision to pay a limited sum is justified both by the breach of contractual obligations by the insured, and by the subsequent consent of the insured, manifested by accepting the paid sum without objection, which led to the closure of the damage regularization process. [...].

In this case, from the findings of the control team, reflected in the Control Act, it results that: "The Insurer cannot invoke the clause by which it is released totally or partially from its obligation if the obligation to inform was not fulfilled in the appropriate manner, except to the extent that, through non-execution, the insurer's interests are seriously affected, in accordance with Art. 1851 para. (3) of the Civil Code. The Insurer, contrary to the obligation to act honestly and respect the rights and interests of the insured deriving from insurance contracts (Art. 89 para. (1) lit. a) and b) of Law No. 92/2022), reduced the amount of insurance compensation. Accordingly, it is established that the insurance compensation paid partially by the insurer and the clauses invoked are subject to absolute nullity under the Civil Code.

5. "[...] Regarding damage file No. […], in which the insured is […], and file No. […], in which the insured is […], we mention that the cases are similar. In both the first and the second case, the parties could not properly justify the expenses invoked, which is why the decision was taken to pay the amounts due within the limits considered justified. No objections were formulated by the insured persons against this decision, accepting the amount of compensation established as real, necessary, and reasonable."

In this context, following the checks carried out, the control team recorded in the Control Act that the insurer, without justified reasons, reduces the amount of insurance compensation, considering that the injured person presented confirmatory documents regarding the expenses borne.

Additionally, it is established that the insurer, in the case of damage files No. […], No. […], No. […] and No. […], did not present information regarding measures taken and did not demonstrate the carrying out of concrete steps towards their resolution.

At the same time, regarding the obligation at point 8 of Decision No. 36/2/2025, the insurer was supposed to review damage files settled during the period 01.01.2024 – 31.12.2024, for the purpose of identifying all cases where unjustified decisions of total or partial refusal to pay insurance compensation were issued to injured persons and remedying these situations accordingly. In this regard, the insurer did not present confirmatory information/documents.

Regarding the administrative procedure, it should be mentioned that, in accordance with Art. 94 of the Administrative Code, via CNPF letter No. 04-5/1447 dated 23.04.2026, the insurer was informed about the exercise of the right to be heard, on 27.04.2026, at 10:30, in relation to the facts and circumstances relevant to the decision to be adopted regarding the administrative procedure, initiated ex officio, aimed at verifying the actions taken by IM CIA "TRANSELIT" SA, in order to execute Decision No. 36/2/2025.

Subsequently, via the message sent on 24.04.2026 from the email address office@transelit.md (registered at CNPF with No. 3009), IM CIA "TRANSELIT" SA confirmed the presence of the Deputy Director General and the Head of the Legal and Compliance Department, who subsequently participated in the hearing, at the date and time cited.

During the hearing, regarding the question about the execution of the obligation prescribed at point 8 of Decision No. 36/2/2025, the insurer's representatives communicated about the appointment of a person responsible for monitoring the processes of processing and regularizing files and revising internal regulations regarding procedures for processing damage files. Additionally, regarding damage files No. […], No. […], No. […] and No. […], the insurer's representatives communicated that the respective files were revised, maintaining the insurer's initial decision in damage files No. […], No. […], No. […]. In the case of damage file No. […], the insurer made the compensation payment. Analyzing all information presented by the insurer both within this administrative procedure and previously, the following is established:

1. with reference to the obligation established at point 7 of Decision No. 36/2/2025 to revise the model of the Insurance Contract and Special Conditions for medical insurance for travel abroad, in order to bring them into conformity with legal provisions, IM CIA "TRANSELIT" SA presented the model of insurance and Special Conditions for medical insurance for travel abroad revised;

2. with reference to the obligation established at point 8 of Decision No. 36/2/2025 to review damage files settled during the period 01.01.2024 – 31.12.2024, in order to identify all cases where unjustified decisions of total or partial refusal to pay insurance compensation were issued to injured persons and remedy these situations accordingly, IM CIA "TRANSELIT" SA carried out the revision of 28 damage files in which, according to the control act, payment of insurance compensation was unjustifiably refused (partially or totally). At the same time, regarding damage files where the decision related to the insured case was not communicated to the injured person, out of 18 files mentioned in the control act, the insurer communicated that in 8 cases it had sent the corresponding decision to the injured persons, attaching receipt notices, without presenting the information letters sent to the persons concerned.

At the same time, the insurer did not carry out the revision of the entire portfolio of damage files settled during the period 01.01.2024 – 31.12.2024;

3. with reference to the obligation established at point 6 of Decision No. 36/2/2025, it is found that its execution depends on the fulfillment of the obligations provided for in points 7 and 8. In conditions where the obligation at point 8 was not fully executed, the obligation provided for at point 6 cannot be considered as fulfilled.

In conclusion, the CNPF finds that the insurer has improperly executed the prescribed obligations, and non-execution of Decision No. 36/2/2025 in its entirety is established. The measures taken were only partial and insufficient to ensure full compliance.

In this context, it should be noted that the arguments mentioned by the insurer cannot be retained as plausible in conditions where Decision No. 36/2/2025 was not contested by IM CIA "TRANSELIT" SA.

Consequently, it should be noted that Decision No. 36/2/2025 represents an individual administrative act, within the meaning of Art. 10 para. (1) of the Administrative Code, namely that "(1) An individual administrative act is any disposition, decision or other official measure taken by the public authority to regulate an individual case in the field of public law, with the aim of producing immediate legal effects, through the birth, modification or extinction of public law legal relations.", as well as an unfavorable act, under Art. 11 para. (1) lit. a) of the same law, which denotes the imposition of an obligation on the insurer. Accordingly, by its nature and legal effects, the Decision is obligatory and subject to execution, under the conditions provided for by normative acts.

In this context, in con