Registered users can save articles to their personal articles list. Login here or sign up here

Long-Term Insurance Ombud takes into account culture, customary law

Old Mutual, Liberty, Hollard top complaints list.

The Ombudsman for Long-Term Insurance (OLTI) has outlined cases in which it considers culture and customary law when resolving disputes between insurers and the insured.

In releasing its annual report for 2017, Ombudsman Ron McLaren noted that statistics provide valuable insight into the period under review but that they sometimes tell only half a story.

To this end, the OLTI’s office has attempted to show the attention to detail given in resolving complaints particularly when it comes to considering the cultural circumstances and customary law of the insured.

In one such case involving a funeral policy, a claim was refused as the insured failed to distinguish between cousin and second cousin. However, the OLTI ruled that the insured ought to be paid out as the term “cousin” includes second cousins in certain South African languages.

Another ruling saw an insurer fight a claim related to the death of a 16-year-old, who died of unnatural causes in 2014. The insurer disputed the validity of the deceased’s alleged customary adoption, which the OLTI recognised as legal. Thereafter, the insurer and complainant reached an amicable settlement.

Overall, the OLTI’s office received 5 435 chargeable complaints in 2017 compared with 5 284 in 2016. It considered 4 336 complaints during the year and closed 3 371 full cases, and in so doing collected R193.3 million for complainants.

At 49.46%, most complaints were about claims denied by insurers. Complaints related to poor service ranked second, with the OLTI compensation of just over R500 000 awarded to 150 complainants for poor service.

As expected, the vast majority of complaints were filed against the country’s largest insurance firms.

Top 5 OLTI complaints in 2017

 

Complaints received

% of Total Complaints received

Cases considered

Cases finalised

WP* Resolved in favour of complainant

WP* Resolved in favour of insurer

Old Mutual Life Assurance

847

15.58%

642

475

25.4%

74.6%

Liberty Group

600

11.04%

504

410

32.4%

67.6%

Hollard

485

8.92%

363

323

35.3%

64.7%

Metropolitan Life

421

7.74%

328

252

30.2%

69.8%

MMI Group

262

4.82%

234

237

24.1%

75.9%

* percentage of cases wholly or partially resolved in favour of complainants or insurers.

Source: Ombudsman for Long-Term Insurance, annual report 2017

Separately, the 2017 South African Customer Satisfaction Index for Life Insurance Companies found that Metropolitan’s customers were most satisfied with their service, with the firm scoring 80.8 points. Old Mutual scored 80.6 points, Discovery Life 76.3 points, Momentum 74.7 points and Liberty 73.9 points. According to Consulta, which polled 2 696 life insurance customers at random, the overall satisfaction score – out of 100 – is based on brands exceeding or falling short of customer expectations and assessing how well a brand is measured against respondents’ perception of the ideal life insurer.

AUTHOR PROFILE

COMMENTS   5

To comment, you must be registered and logged in.

LOGIN HERE

Don't have an account?
Sign up for FREE

Complaints rated the highest at those companies that communicate digitally and not face to face with a human being. It’s impossible to engage with Old Mutual personally hence their high complaint rate. Just my experience for what it’s worth.

@Mactheknife………100% !!!!

The sheer frustration at big corporates growing tendency to AUTOMATE and DIGITIZE customer service is one of the biggest mistakes.

In fact, most interactions need to be MORE human interacted, as with any business dealings its generally always on a case by case basis !!!

So, how does this get automated ???????

Impossible, hence all the frustrations and messed up claims due to LACK OF COMMUNICATION

Jsus, dont spend millions on fancy tv ads promising the ‘human touch’ etc etc

Rather JUST ANSWER YOUR FRIGGIN PHONE PLEASE !!!!!!!!

Old Mutual still no. 1. I cannot wait for the advertising campaign.

Load All 5 Comments
End of comments.

LATEST CURRENCIES  

ZAR / USD
ZAR / GBP
ZAR / Euro
Separating out the noise from useful information in the markets is not easy. The trick to staying the course is to keep an eye on the big picture. And read the latest Moneyweb Investor.

Podcasts

GO TO SHOP CART

Follow us:

Search Articles:Advanced Search
Click a Company:
server: 172.17.0.2