The Ombudsman for Long-term Insurance (Ombud) released its Annual Report for 2019. The Report provides statistics on complaints received by the office with a trend of increasing funeral complaints.
In summary, the following statistics were released:
- 11 915 written requests for assistance were received compared to 11 768 in 2018 (an increase of 147 requests).
- The percentage of cases resolved, wholly or partially, in favour of complainants increased from 31.5% to 34.12%.
- the percentage of complaints finalised within six months remained at 91% as in 2018.
- R200.4 million was recovered for complainants in the form of lump sums. This figure does not reflect the value of all benefits awarded in favour of complainants, such as recurring income disability benefits, annuities, the reinstatement of policies, etc.
- 469 policy cancellation requests were received from policyholders.
Statistics based on the Nature of Complaints (across Life, Disability, Health, and Funeral policies)
Statistics based on Complaints Categorisation according to TCF outcomes and Policyholder Protection Rules
Complaints recorded according to the Treating Customers Fairly outcome categories as stipulated in the Policyholder Protection Rules reveal the highest number of complaints for 2019 were for Insurance risk claims at 58.7% with Service to policyholders coming in second at 13% while complaints for Advice amounted to 0.8%.
In addition to statistics, the Report also provides insight on other aspects such as: matters of interest on non-disclosure and the Didcott principle, Practice note on interest, trends, and case reports of final determinations against insurers.
We recommend that FSPs who deal in long-term insurance products take time to read the Ombud’s full comments in the report. This can be used as the basis to review the advice process followed, to ensure full compliance with the requirements and fair treatment of customers.