Insurance in Macedonia

Insurance is locally called осигурување (osiguruvanje). The insured person is the осигуреник, the insurer is the осигурител, the policy is an осигурителна полиса, the premium is a премија, and a claim or loss is a штета. Insurance may be statutory, where rights and contributions follow legislation, or private, where the policy defines the cover, limits, exclusions, deductible, premium and claim procedure. Statutory social insurance includes pension and disability insurance, mandatory health insurance and unemployment insurance. From 1 July 2026, the contribution rates listed in the applicable system are 19.9% for pension and disability insurance, 7.5% for health insurance, 0.5% for the work-injury and occupational-disease add-on, and 0.1% for unemployment insurance. The contribution legislation determines the liable person, contribution base, calculation, payment deadlines and control. The exact payment obligation depends on the employment, self-employment or other statutory basis. The Health Insurance Fund (FZO) provides mandatory health insurance through a statutory insurance basis. Family members can be included when they are not insured on another basis. An employer reports the start of employment, normally using the relevant registration such as ZO1 and M1, and the insured person uses the health card and supporting documents when dealing with a local FZO office. When the insurance basis ends, de-registration must take place within a maximum of eight days. Co-payments and exemptions follow the health-insurance legislation. If the first-instance deadline is missed, the FZO Director must decide within five days after the escalation. Medical treatment details belong to the health-services system rather than to this insurance overview. The Employment Service Agency (ESA/AVRM) administers unemployment-insurance benefits. Eligibility generally requires at least nine uninterrupted months of insurance or twelve interrupted months within the previous eighteen months. Payment lasts from one to twelve months depending on insurance seniority. The benefit is 50% of the average net salary during the previous 24 months, subject to a maximum of 80% of the national average salary. Beneficiaries must register with an employment centre and report every 30 days. The first pension pillar uses generational solidarity through PIOM/PADIFNM. The old-age threshold is generally 64 for men and 62 for women, together with at least 15 years of pension service. The system also covers disability, work-injury and survivor rights under their specific conditions. The second and third pillars are fully funded pension insurance administered through licensed pension companies and custodian banks under MAPAS supervision. The second pillar is mandatory for eligible participants and the third is voluntary. Transfers and withdrawals follow MAPAS rules; these funds are not the same as ordinary private life insurance. Private insurance is supervised by the Insurance Supervision Agency (ISA). Only ISA-authorized insurers, agents, agencies, brokers, actuaries and reinsurers may provide the relevant services. Available products include compulsory motor third-party liability insurance (MTPL), casco, property and building insurance, household contents insurance, cargo insurance, liability insurance, agricultural insurance, life insurance, accident insurance, private health insurance, travel insurance and financial-loss cover. Private health insurance may add reimbursement, co-payment support or access to higher-standard or out-of-network services, but its scope depends on the policy. MTPL is compulsory for vehicles, and its premium tariff is regulated. The National Insurance Bureau (NIB) issues or authorizes Green Cards and coordinates cross-border motor-liability matters. An electronic PDF Green Card has been accepted in the Green Card area, including North Macedonia, since 1 January 2025. The NIB Guarantee Fund addresses defined cases such as uninsured or unknown vehicles, uninsured passenger transport, certain claims involving a failed insurer and selected cross-border guarantees. After a traffic accident, the injured party normally claims first against the liable insurer. Court proceedings follow the required out-of-court procedure, and mediation may also be available. When taking out private cover, check the insurer or intermediary in the ISA registers. Read the policy and special conditions together, including the insured sum, limits, exclusions, deductible, premium, validity period, renewal and cancellation rules. Cover begins and continues according to the contract and the applicable premium conditions. There is no universal private-insurance tariff; premiums depend on the product and risk, while MTPL follows its regulated tariff. Notify the insurer promptly after a covered event and preserve the policy, invoices, medical or police records, ownership evidence and other proof relevant to the claim. Submit a written complaint to the insurer first. The insurer must respond within a maximum of 30 days. If the response is missing or unsatisfactory, a complaint can be filed with ISA using the required form and documents. ISA supervises legality and procedure but does not decide disputed civil liability or the amount of damage. ISA does not handle anonymous complaints or matters already pending before a court; civil disputes about the basis or amount of compensation belong before the courts. Changing cover usually requires an endorsement, renewal or termination under the contract. Switching private insurers requires a new policy because cover does not transfer automatically. Changes in statutory insurance status are handled through the relevant employer, Public Revenue Office (UJP/PRO), FZO, PIOM/PADIFNM or ESA pathway. Pension-fund transfers follow MAPAS rules. A vehicle must have continuous MTPL cover before it can be used lawfully on public roads.