Insurance Ombudsman

Do you have a complaint about an Insurance company !

The purpose of the Short Term Insurance Ombudsman is to resolve disputes between members and insured consumers in an independent, impartial, cost-effective, efficient, informal and fair way.

The Ombudsman’s task is to act as a “mediator” or informal arbitrator and he/she does not represent either of the parties to the dispute.

There service is free to consumers, but you must follow their guidelines when making a complaint.

You must complain to the Insurance Company first, before they can look at your complaint. Here are some hints to help you complain effectively to the Insurer and details of what to do next if you are still unhappy with their decision.

1. It is usually best to complain in writing. But if you phone, ask for the name of the person you speak to. Keep a note of this information, with details such as, the date and time of your call and what was said. This may be required at a later stage.

2. Remain calm and polite, however emotional, angry or upset you may be. You are more likely to explain your complaint clearly and effectively if you can stay calm.

3. Initially attempt contacting the person you originally dealt with. If they cannot help, indicate that the matter will be taken further. Seek details of the name or job title of the person who will be handling your complaint and for details of the Insurer’s complaints procedure. Attempt taking up the matter with a Senior Official at the Insurer.

4. When you write a letter of complaint, set out the facts as clearly as possible.

5. Write down the facts in a logical order and stick to what is relevant. Include important details like your claim number or your policy number.

6. Keep a copy of any letters between you and the Insurer.

What to do next:

If you are not happy with the Insurer’s decision you may:

1. Issue a summons out of the Small Claims Court ( there is a small cost involved ) on the Insurance Company . The maximum amount that can be claimed in the Small Claims Court is R 3000,00.

2. Consult with an Attorney to pursue the matter by means of further legal action .

3. We may be able to help. You will need to fill in our complaint form and send it back to us.

For more detailed information – Click here to visit their website